Perfil de proteínas pró-inflamatórias e citocinas pró-inflamatórias e anti-inflamatórias em mulheres exantemáticas com infecção por vírus Zika atendidas em uma unidade de saúde referência em doenças infecciosas em Manaus, Amazonas

Abstract

The Zika virus is a flavivirus first identified in Uganda in 1947. The main vector is the Aedes aegypti mosquito. The disease can present an exanthematous condition that is associated with mild manifestations such as fever and arthralgia and more complicated forms such as Guillain-Barré syndrome in the adult population and congenital syndrome in children exposed to the virus intrauterinely. The study is a descriptive case series and aims to describe the profile of pro-inflammatory proteins and pro-inflammatory and anti-inflammatory cytokines in women of childbearing age with positive and negative exanthematous disease for the Zika virus. Of these inflammatory proteins, we analyzed positive inflammatory biomarkers such as α1-acid glucrotein, ceruloplasmin, haptoglobin, complement proteins C3 and C4, and ferritin, and negative inflammatory biomarkers such as albumin and transferrin. We also evaluated the liver function and kidney function of these patients. All measurements were carried out on an Architect biochemical analyzer, except for ferritin, which was measured on an immunological analyzer. We analyzed the profile of 26 cytokines and chemokines in these patients using the luminex technique. In our results we found in the positive controls, exanthematic Zika patients, an increase only in the positive inflammatory biomarker C-reactive protein and in additional tests, γ-GT, and in the negative controls, negative Zika exanthematic patients, the same occurred, but with an increase of α1-acid glycoprotein and in liver function tests, markers were slightly increased. In the profile of 26 cytokines, we found in both controls the presence of cytokines that indicated the response of Th1, Th2 and Th9 cells. At the conclusion of our studies, we observed the virus circulating in Manaus, an increase in only one positive inflammatory biomarker, C-reactive protein, and an increase in γ-GT in additional tests. And no negative biomarkers showed a significant increase. In the profile of the 26 cytokines analyzed, an increase in CXCL-10 (IP-10) and IL-5 in Zika rashes attracted attention. The presence of IL-12p40 and IL-15 may be related to viral infection and the presence of IL-9 with a modulatory role.