{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:05:05Z","timestamp":1778670305614,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T00:00:00Z","timestamp":1577750400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004835","name":"Zhejiang University","doi-asserted-by":"publisher","award":["491010\u2217A61703"],"award-info":[{"award-number":["491010\u2217A61703"]}],"id":[{"id":"10.13039\/501100004835","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004835","name":"Zhejiang University","doi-asserted-by":"publisher","award":["2017ZX10202101-002-006"],"award-info":[{"award-number":["2017ZX10202101-002-006"]}],"id":[{"id":"10.13039\/501100004835","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004835","name":"Zhejiang University","doi-asserted-by":"publisher","award":["2018ZX10302104"],"award-info":[{"award-number":["2018ZX10302104"]}],"id":[{"id":"10.13039\/501100004835","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science and Technology Major Project of China","award":["491010\u2217A61703"],"award-info":[{"award-number":["491010\u2217A61703"]}]},{"name":"Science and Technology Major Project of China","award":["2017ZX10202101-002-006"],"award-info":[{"award-number":["2017ZX10202101-002-006"]}]},{"name":"Science and Technology Major Project of China","award":["2018ZX10302104"],"award-info":[{"award-number":["2018ZX10302104"]}]},{"name":"Science and Technology Major Project of China","award":["491010\u2217A61703"],"award-info":[{"award-number":["491010\u2217A61703"]}]},{"name":"Science and Technology Major Project of China","award":["2017ZX10202101-002-006"],"award-info":[{"award-number":["2017ZX10202101-002-006"]}]},{"name":"Science and Technology Major Project of China","award":["2018ZX10302104"],"award-info":[{"award-number":["2018ZX10302104"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2019,12,31]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. Serum cytokines\/chemokines play important roles in cryptococcal meningitis, but it is unclear whether cytokines\/chemokines in cerebrospinal fluid (CSF) contribute to high intracranial pressure (HICP) in HIV-associated cryptococcal meningitis (HCM). <jats:italic>Methods<\/jats:italic>. CSF cytokines\/chemokines were assayed in 17 HIV-uninfected patients, 26 HIV-infected patients without CNS infection, and 39 HCM patients at admission. Principal component analysis and correlation and logistic regression analyses were used to assess the relationships between these parameters. <jats:italic>Results<\/jats:italic>. The CSF Th1, Th2, and macrophage cytokines showed an obvious increase in HCM patients as compared to the HIV-uninfected patients and HIV-infected patients without CNS infection. CSF IL-6, GM-CSF, and IL-8 were positively correlated with CSF fungal burden. Serum CD4 count, CSF Th1 cytokines (TNF-<jats:italic>\u03b1<\/jats:italic>, TNF-<jats:italic>\u03b2<\/jats:italic>, IL-12, IL-1<jats:italic>\u03b2<\/jats:italic>, and INF-<jats:italic>\u03b1<\/jats:italic>2), and Th2 cytokines (IL-5 and IL-6) were closely related to cryptococcal meningitis. Furthermore, both Th1 cytokines (TNF-<jats:italic>\u03b1<\/jats:italic>, TNF-<jats:italic>\u03b2<\/jats:italic>, INF-<jats:italic>\u03b3<\/jats:italic>, and IL-12) and Th2 cytokines (IL-4 and IL-10) contribute to HICP. <jats:italic>Conclusion<\/jats:italic>. Overall, the present findings indicated that both pro- and anti-inflammatory cytokines of Th1, Th2, and macrophage origin contributed to the development of HCM. Specifically, the chemokine and cytokine cascade caused by skewing of the Th1-Th2 balance and reduced CD4 count were found to be important contributors to HICP. <jats:italic>Summary<\/jats:italic>. Our research suggested that chemokine and cytokine cascade caused by skewing of the Th1-Th2 balance in HIV-infected patients played more important role than Cryptococcus numbers and size in CSF on the development of high intracranial pressure in HIV-associated cryptococcal meningitis, providing a new understanding of mechanisms of HCM.<\/jats:p>","DOI":"10.1155\/2019\/2053958","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T18:30:45Z","timestamp":1577817045000},"page":"1-9","source":"Crossref","is-referenced-by-count":17,"title":["Chemokine and Cytokine Cascade Caused by Skewing of the Th1-Th2 Balance Is Associated with High Intracranial Pressure in HIV-Associated Cryptococcal Meningitis"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7352-2086","authenticated-orcid":true,"given":"Lijun","family":"Xu","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Infectious Diseases, The 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