Iranian Journal of Medical Microbiology

en Co-Analysis of TLR7 and CCL2 as Predictive Biomarkers forH1N1 Influenza Infection Severity ویروس شناسی پزشکی Medical Virology مقاله پژوهشی Original Research Article Background and Aim: Influenza A virus (H1N1) infection is still a high risk disease that involves inflammatory reactions. Chemokine (C-C motif) ligand 2 (CCL2) and Toll-like receptor 7 (TLR7) are important elements of immune system that regulate antiviral and inflammatory responses. This study aimed to assess the combined diagnostic and prognostic importance of TLR7 and CCL2, and investigate their relationship with clinical parameters and disease severity of H1N1. Materials and Methods: In this case-control study, 60 influenza patients (divided into influenza-like illness [ILI] and severe acute respiratory infection [SARI] groups) were included along with 30 healthy people that served as control group. Blood samples were used to evaluate the expression of the TLR7 gene using RT-qPCR. The levels of CCL2 were measured using ELISA. ROC curve analysis, multivariate logistic regression, spearman correlation, and nonparametric tests were used to analyze the clinical data. Results: H1N1 patients showed considerably higher levels of TLR7 expression than controls (median 8.6 vs 1.6; P<0.001). WBC and CRP levels were positively linked with elevated levels of TLR7. On the other hand, CCL2 was significantly lower in SARI group compared to ILI patients (37.5 vs 87.4 pg/mL; P<0.001). Predictive AUCs of 0.75 for TLR7 and 0.79 for CCL2 were found using ROC analysis; the combined model increased AUC to 0.85 (95% CI, 0.73–0.91). The presence of disease severity and diabetes was substantially correlated with both biomarkers. Conclusion: In severe H1N1 infection, both CCL2 downregulation and TLR7 overexpression indicate increased immunological activity and inflammatory reactions dysregulation. The prognostic accuracy for identifying patients at risk of severe influenza is improved by their combined profiling. Biomarker, CCL2, Cytokine, H1N1, ILI, Influenza, Innate Immunity, TLR7, SARI 341 353 http://ijmm.ir/browse.php?a_code=A-10-2946-1&slc_lang=en&sid=1 Raghad KH Maeh raghadnoor79@gmail.com 100319475328460033727 100319475328460033727 Yes Department of Biotechnology, College of Applied Science, University of Technology, Baghdad, Iraq Ahmed Issa AL-Tameemi Ahmed.T@aliraqia.edu.iq 100319475328460033728 0009-0004-0056-1569 No Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq Zainab S Mahmood zainabbio86@gmail.com 100319475328460033729 0009-0005-6532-7009 No Department of Basic Sciences, College of Dentistry, University of AL-Iraqia, Baghdad, Iraq Hula Y. Fadhil hula.younis@sc.uobaghdad.edu.iq 100319475328460033730 100319475328460033730 No Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq Khalida.F AL-azawi khalida.f.alazawi@uotechnology.edu.iq 100319475328460033731 100319475328460033731 No Department of Biotechnology, College of Applied Science, University of Technology, Baghdad, Iraq