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Summary The haemophagocytic syndrome (HPS) is a rare but frequently fatal disorder of immune regulation caused by hypercytokinemia. Using cytometric bead array technique, the serum T‐helper cell type 1 (Th1) and 2 (Th2) cytokines including interferon‐γ (IFN‐γ), tumour necrosis factor (TNF), interleukin (IL)‐10, IL‐6, IL‐4 and IL‐2 were determined in 24 children with de novo HPS and 87 children as control. The median levels of serum IFN‐γ, IL‐10 and IL‐6 in the acute phase of HPS were 901·7, 879·0 and 63·8 pg/ml, respectively, significantly higher than those after remission, and in the healthy volunteers and patients with viral infection. IL‐4 was slightly elevated while IL‐2 and TNF were within normal range in acute phase. Patients with bacterial sepsis showed an extremely high level of IL‐6 and moderate level of IL‐10, whereas IFN‐γ was only slightly elevated. Five patients were diagnosed with HPS according to the Th1/Th2 cytokine pattern 3–13 d earlier than they fulfilled the relevant diagnostic criteria. IL‐10 level >2000 pg/ml was an unfavorable prognostic factor for HPS treatment response (P = 0·033) and outcome (P = 0·009). We conclude that the significant increase of IFN‐γ and IL‐10 and a slightly increased level of IL‐6 is an early, specific and prognostic cytokine pattern for childhood HPS.

Articles you may be interested inSingle-molecule stochastic times in a reversible bimolecular reaction J. Chem. Phys. 137, 084106 (2012); 10.1063/1.4747337 Mass fluctuation kinetics: Capturing stochastic effects in systems of chemical reactions through coupled meanvariance computations

The relationship between event-averaged measurements and ensemble averaged measurements can be clarified by averaging along single-molecule trajectories. As a result, phenomenological chemical kinetics is shown to contain little information about dynamic disorder, and nonequilibrium relaxation experiments in the bulk state may not be interpreted according to the fluctuation-dissipation relation. The desired information about conformational fluctuations can be inferred from the statistics and correlation of half-reaction events. In particular, the echo time in the two-event probability distribution directly measures the conformational relaxation rate, and the amplitude of the echo probes the variance of the reaction rate. Detailed analysis of four different models (two-channel kinetic scheme, three-channel kinetic scheme, diffusion-modulated reaction, and the Gaussian stochastic rate model) confirms the generality of the two-event echo and its quantitative relations with conformation dynamics. As a general description of the fluctuating rate process, the stochastic rate model and its truncated version provide the flexibility to incorporate various kinetic schemes and functional forms and serve as a first-order model for analyzing single-molecule quantities.

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