Inflammatory responses in Ebola virus-infected patients

Clin Exp Immunol. 2002 Apr;128(1):163-8. doi: 10.1046/j.1365-2249.2002.01800.x.


Ebola virus subtype Zaire (Ebo-Z) induces acute haemorrhagic fever and a 60-80% mortality rate in humans. Inflammatory responses were monitored in victims and survivors of Ebo-Z haemorrhagic fever during two recent outbreaks in Gabon. Survivors were characterized by a transient release in plasma of interleukin-1beta (IL-1beta), IL-6, tumour necrosis factor-alpha (TNFalpha), macrophage inflammatory protein-1alpha (MIP-1alpha) and MIP-1beta early in the disease, followed by circulation of IL-1 receptor antagonist (IL-1RA) and soluble receptors for TNFalpha (sTNF-R) and IL-6 (sIL-6R) towards the end of the symptomatic phase and after recovery. Fatal infection was associated with moderate levels of TNFalpha and IL-6, and high levels of IL-10, IL-1RA and sTNF-R, in the days before death, while IL-1beta was not detected and MIP-1alpha and MIP-1beta concentrations were similar to those of endemic controls. Simultaneous massive activation of monocytes/macrophages, the main target of Ebo-Z, was suggested in fatal infection by elevated neopterin levels. Thus, presence of IL-1beta and of elevated concentrations of IL-6 in plasma during the symptomatic phase can be used as markers of non-fatal infection, while release of IL-10 and of high levels of neopterin and IL-1RA in plasma as soon as a few days after the disease onset is indicative of a fatal outcome. In conclusion, recovery from Ebo-Z infection is associated with early and well-regulated inflammatory responses, which may be crucial in controlling viral replication and inducing specific immunity. In contrast, defective inflammatory responses and massive monocyte/macrophage activation were associated with fatal outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / blood
  • Antibodies, Viral / blood
  • Antigens, Viral / blood
  • Biomarkers / blood
  • Cytokines / blood
  • Disease Outbreaks
  • Ebolavirus / immunology
  • Female
  • Gabon / epidemiology
  • Hemorrhagic Fever, Ebola / diagnosis
  • Hemorrhagic Fever, Ebola / epidemiology
  • Hemorrhagic Fever, Ebola / immunology*
  • Hemorrhagic Fever, Ebola / mortality
  • Humans
  • Immunoglobulin G / blood
  • Inflammation / blood
  • Inflammation Mediators / blood
  • Kinetics
  • Male
  • Prognosis
  • Survivors


  • Anti-Inflammatory Agents
  • Antibodies, Viral
  • Antigens, Viral
  • Biomarkers
  • Cytokines
  • Immunoglobulin G
  • Inflammation Mediators