Background: Human cytomegalovirus (CMV) is a chronic viral infection that causes chronic immune activation and dysregulated cytokine signaling. In viral infections, proinflammatory cytokine plays a pivotal role in enhancing inflammatory cascades, and orchestrates host immune responses. may reflect the extent of immune activation and could also lead to the progression of diseases.
Objective: The aim of the present study was to critically assess the proinflammatory cytokine profile in CMV-infected females by measuring serum levels of IL-17, TNF-alpha, and C-reactive protein (CRP) and to determine their combined utility as biomarkers of systemic immune activation.
Methods: A case-control study was done on a sample of 60 female patients with a confirmed CMV infection (diagnosed by serological and/or molecular means) attending the Al-Sadr Teaching Medical City in Najaf, Iraq, and 30 healthy female controls. The study participants included 20-55 years of age. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of IL-17, TNF-α, and CRP. All assays were performed in duplicate to provide analytical reliability. Statistical analysis was done with SPSS (version 25) and independent t-tests were used to compare groups and Pearson correlation was used to measure association between cytokines. A P-value < 0.05 was considered statistically significant.
Results: There was a significant increase in serum levels of IL-17, TNF-a and CRP in CMV infected patients relative to healthy individuals (P less than 0.0001). The significant rise in IL-17 levels reflects the activation of Th17-mediated immune pathways, which lead to the increased inflammatory signaling and recruitment of immune cells. Simultaneous up-regulation of TNF-a further enhances the inflammatory response, and supports the existence of a synergistic IL-17/TNF-a axis. Also, the CRP increase is an indicator of systemic inflammation and an engagement in the acute-phase response. It was found that there is a positive correlation between IL-17 and TNF-α levels indicating that proinflammatory signaling is coordinately regulated.
Conclusion: A strong and orchestrated proinflammatory immune response marked by high upregulation of IL-17, TNF-α and CRP is associated with CMV infection in females. The IL-17/TNF-α interaction is a critical (axis) that drives immune activation and can be a powerful biomarker of inflammatory status in CMV infection. These results have significant implications on CMV immunopathogenesis and the identification of possible targets that can be therapeutically modulated. To quantify their prognostic value and association with the severity of the disease, further longitudinal studies are justified.