Diagnostics
Convergent Immunopathology in Influenza-Associated Encephalopathy: CD3+ CD4+ T Cell Depletion, IL-6-Mediated Inflammation, and Complement C3 Dysregulation
By Dongmei Zhang, Yang Chen, Ling Hu and 3 others.
Abstract
Background
Influenza-associated encephalopathy (IAE) is a severe neurological complication, yet immune biomarkers for its early prediction remain limited. This study aimed to elucidate the systemic immune signature defining IAE by integrating humoral and cellular immunity analyses.
Methods
We conducted a retrospective cohort study of 623 pediatric influenza patients presenting with fever and convulsions (55 IAE, 568 febrile seizure (FS) group) at Wuhan Children’s Hospital (2020–2025). Serum complement components (C3, C4), lymphocyte subsets (including CD3+ CD4+, CD3+ CD8+, CD19+ B cells, and NK cells), and cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α) were quantified. Multivariable logistic regression was performed, rigorously adjusted for age, sex, influenza subtype, time from fever onset to sampling, prior use of intravenous immunoglobulin (IVIG) or glucocorticoids, and pre-diagnostic convulsive episodes. Sensitivity analysis via 5th-percentile Winsorization addressed floor effects in C3 measurements.