Elevated chemokine levels during adult but not pediatric crimean-congo hemorrhagic fever

Background: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonosis. Clinical reports indicate the severity of CCHF is milder in children than adults. The chemokines are important chemo-attractant mediators of the host immune system. Objectives: The main aim of the study was to identify whether or not there were any differences in chemokine levels between the pediatric and adult patients and control groups, and whether there was any correlation with disease severity. Study design: The serum levels of select chemokines including chemokine (C-C) ligand 2 (CCL2), CCL3, CCL4, chemokine (C-X-C) ligand 8 (CXCL8), CXCL9, and granulocyte-colony stimulating factor (G-CSF) in 29 adult and 32 pediatric CCHF patients and in 35 healthy children and 40 healthy adult control groups were studied by flow cytometric bead immunoassay method. Results: Great variability was detected in the serum levels of the chemokines for both the adult and pediatric patients and controls. With the exception of G-CSF, the median serum levels of CCL2, CCL3, CCL4, CXCL8, and CXCL9 were found to be significantly higher in the adult patients compared to adult controls (2364.7 vs. 761. pg/ml; 714.1 vs. 75.2. pg/ml; 88.6 vs. 25.5. pg/ml; 217.9 vs. 18.3. pg/ml; 875 vs. 352.2. pg/ml, respectively, p<. 0.0001 for all comparisons). Among the chemokines the median CCL4 and G-CSF levels were significantly higher in the pediatric patients compared to pediatric controls (40.3 vs. 7.1. pg/ml, p<. 0.0001; 0.1 vs. 0.1. pg/ml, p= 0.049, respectively). Conclusion: The results of this study showed prominent chemokine raising in adult CCHF patients compared to children CCHF patients.