Dysregulation of cytokine profiles plays a crucial role in the pathogenesis of scrub typhus-associated acute kidney injury.

BACKGROUND

OBJECTIVES

Scrub typhus (ST) is a serious mite-bome disease which is recently considered as underrecognized cause of acute kidney injury (AKI). The current study was undertaken to elucidate finer details of the role of inflammatory response in the pathophysiology of scrub typhus associated AKI (STAKI).

METHODS

This prospective study was carried out on patients admitted to the Department of Nephrology, SCB Medical College and Hospital, Cuttack, India, a tertiary care hospital of the state. All sera were tested for O. tsutsugamushi using IgM ELISA kit and PCR assay. The serum level cytokines were detected by using commercially available ELISA kits.

RESULTS

The study reveals that 31.4% of the hospitalized AKI samples were positive for scrub typhus. IL-33, IL-17, TNF-α, IFN-γ and Ang-2 were significantly high in both scrub typhus associated febrile patients and STAKI patients. However, IL-17, TNF-α and Ang-2 were found to be significantly high in STAKI patients in comparison to scrub typhus associated febrile patients. Further, significantly high expression of IL-10 was observed in both groups of scrub typhus patients with and without AKI.

INTERPRETATION

CONCLUSION

Significantly high levels of IL-17, TNF-α and Ang-2 in STAKI patients showed the dysregulated inflammatory response during pathogenesis and can be used as potential biomarkers for monitoring disease progression. However, more studies are needed to shed light on delineating the mechanism which will help in developing future therapeutic target for the management of this neglected tropical disease.