Cytokine Profile in JE and non JE Encephalitis

Background & Objectives Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes. Acute Encephalitis Syndrome due to unidentified causes has been an issue of concern in eastern Uttar Pradesh. This study was undertaken to study the cytokine response in JE and non JE AES. Methodology This prospective study was performed in patients with acute encephalitis syndrome (AES) aged 1 to 15 years who had been admitted to a tertiary care teaching hospital. Patients who tested positive for typhoid, malaria, measles, mumps, herpes (HSV), Dengue were excluded. Serum and CSF samples of JE positive and non JE cases were further analysed for cytokine levels - Tumor necrosis factor -, Interferon-, Interleukin-10 and chemokines interferon activated protein-10 and RANTES. Results 12 were positive for JE IgM and 58 cases were from the Non JE category in which no aetiology was detected. Cytokines were tested in 45 patients, 12 were of JE and rest 33 of non JE. CSF level of IFN-, IL-10 and IP-10 were significantly higher in Non JE patients than in JE patients. IP-10 cut off levels in CSF of more than 1223.24 were helpful in differentiating non JE from JE with a sensitivity of 72.73 % and specificity of 66.63 %. Conclusion This study highlights the differences in immunological response of the JE and non JE cases. Interferon gamma inducible protein-10 (IP-10), a chemokine was siginificantly increased in the non JE group and turned out to be a fairly sensitive test in differentiating JE from non JE.