Journal
FRONTIERS IN PHARMACOLOGY
Volume 7, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fphar.2016.00082
Keywords
Enterovirus 71; brain stem encephalitis; pulmonary edema; milrinone; inflammation
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Funding
- Ministry of Science and Technology Taiwan [MOST 104-2321-B-006-016, MOST 105-2321-B-006-008]
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Taiwan
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Enterovirus 71 (EV71) was implicated in a widespread outbreak of hand-foot-and-mouth disease (HFMD) across the Asia Pacific area since 1997 and has also been reported sporadically in patients with brain stem encephalitis. Neurogenic shock with pulmonary edema (PE) is a fatal complication of EV71 infection. Among inotropic agents, milrinone is selected as a therapeutic agent for EV71-induced PE due to its immunopathogenesis. Milrinone is a type III phosphodiesterase inhibitor that has both inotropic and vasodilator effects. Its clinical efficacy has been shown by modulating inflammation, reducing sympathetic over-activity, and improving survival in patients with EV71-associated PE. Milrinone exhibits immunoregulatory and anti-inflammatory effects in the management of systemic inflammatory responses in severe EV71 infection.
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