Assessment of Th1/Th2 cytokines among patients with Middle East respiratory syndrome coronavirus infection

Abstract Middle East respiratory syndrome coronavirus (MERS-CoV) is a member of the beta-coronavirus genus of zoonotic origin that emerged in the Arabian Peninsula and is associated with significant morbidity and mortality. This study was conducted to assess the plasma levels of cytokines to evaluate the Th1/Th2 status among 46 MERS-CoV-infected patients (19 asymptomatic and 27 symptomatic) and 52 normal healthy controls using a customized luminex kit. Comparative analysis of data between MERS-CoV-infected patients and normal healthy controls revealed that although no difference was observed between asymptomatic MERS-CoV patients and controls, the mean plasma levels of interleukin (IL)-10 (44.69 ± 40.04 pg ml−1 versus 14.84 ± 6.96 pg ml−1; P < 0.0001), IL-4 (22.46 ± 8.02 pg ml−1 versus 16.01 ± 9.97 pg ml−1; P < 0.0001), IL-5 (10.78 ± 2.86 pg ml−1 versus 8.06 ± 1.41 pg ml−1; P < 0.0001) and IL-13 (14.51 ± 3.97 pg ml−1 versus 11.53 ± 4.16 pg ml−1; P < 0.003) in MERS-CoV symptomatic patients were significantly higher than the normal controls. The mean plasma levels of interferon (IFN)-γ and IL-12 were no different among the study groups. The cytokine profile among symptomatic MERS-CoV-infected patients was skewed to a Th2 type immune response.