Research Article
Masashi Yoshida, Hideo Matsuda
Abstract
Objective: We set out to establish a prognostic indicator for Cytomegalovirus (CMV) infection and determine the extent of CMV invasion. Design: For five cases of fetal CMV infection treated at our facility, we measured the levels of NSE, S-100β, and GFAP, and we conducted a comprehensive analysis of cytokines to compare with the clinical course. Results: NSE for cases 1 and 4 increased significantly from 10 to 78 ng/ml, and from 15.0 to 30.0 ng/ml, respectively. On the other hand, NSE in Case 3 showed a major decrease from 220.0 to 9.6 ng/ml, while that of Case 2 remained in the normal range and that of Case 5 fluctuated slightly from 13 to 15 ng/ml. In all cases, almost no changes in S-100β and GFAP were observed during the course of treatment. Conversely, our comprehensive analysis detected no expression of cytokines, such as TNF-α and IL-2. But IP-10, a monocytic chemotactic factor, revealed a tendency for high levels; 766.2 ± 716.1 pg/ml vs 155.0 ± 104.1 pg/ml (mean ± S.D.) (p=0.077). Conclusion: Our results suggest that an increased NSE level with fetal CMV infection indicates nerve damage associated with CMV. Moreover, the absence of inflammatory cytokines suggests an immature cell-mediated immune response in the infected fetus.