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BackgroundAlthough there have been a number of studies on the pathogenesis of Crimean-Congo hemorrhagic fever (CCHF) recently, knowledge on this topic is still insufficient. This study aims to reveal the kinetics of serum CCHF virus (CCHFV) titers, serum levels of anti-CCHFV immunoglobulin (Ig)G, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, and interferon (IFN)-γ in CCHF patients.MethodsIn total, 31 CCHF cases (11 fatal) were studied. Serum samples were obtained daily from all patients from the time of admission and continued for a 7-day hospitalization period for serologic (ELISA), virologic (real-time PCR), and cytokine (ELISA) analysis.ResultsThe mean serum CCHFV titer at admission was 5.5E + 09 copies/mL in fatal cases and 5.7E + 08 copies/mL in survivors (p < 0.001). Compared to survivors, both the mean serum levels of IL-6 and TNF-α at admission were found to be significantly increased in fatal cases. The serum levels of IL-6, TNF-α and serum CCHFV titer at admission were significantly and positively correlated with disseminated intravascular coagulation (DIC) scores (r = 0.626, p = 0.0002; r = 0.461, p = 0.009; and r = 0.625, p = 0.003, respectively). When the data obtained from the sequential determination of CCHFV titer and levels of anti-CCHFV IgG, IL-6, TNF-α, IL-10 and IFN-γ were grouped according to the days of illness, the initial serum CCHFV titer of a fatal patient was 5.5E + 09 (copies/mL) and it was 6.1E + 09 (copies/mL) in a survivor on the 2 day of illness. While significant alterations were observed in all cytokines during the monitoring period, IL-6 levels remained consistently higher in fatal cases and TNF-α levels increased in both in fatal and non-fatal CCHF cases.ConclusionsThe increased CCHFV load and higher concentrations of IL-6 and TNF-α, the presence of DIC, and the absence of CCHFV specific immunity are strongly associated with death in CCHF.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-416) contains supplementary material, which is available to authorized users.

This study was designed to examine the in vitro antimicrobial and antioxidant activities and the amount of total phenolics of the methanol extracts of Ballota rotundifolia L. and Teucrium chamaedrys C. Koch. In the case of antimicrobial activity tests, polar sub-fractions of the methanol extracts of plant species exhibited weakest antimicrobial activity when compared with the non-polar ones. While, non-polar sub-fraction of B. rotundifolia showed moderate activity against A. lwoffii, C. perfringens and the yeasts, T. chamaedrys performed excellent activity pattern against all of the tested microorganisms. The sub-fractions were also screened for their possible antioxidant activities by two complementary tests, namely DPPH free radical-scavenging and beta-carotene/linoleic acid assays. Non-polar extracts of the plant species remained inactive in both test systems. On the other hand polar extracts showed remarkable antioxidant activities. In DPPH system, free radical scavenging effect of T. chamaedrys was measured as 18.00 +/- 1.42 microg.mg(-1). It is extremely important to point out that, polar sub-fraction of T. chamaedrys is found as effective as the positive control BHT. Non-polar sub-fraction of T. chamaedrys found to have the highest total phenolic amount (97.12 +/- 1.28 microg/mg). Results obtained from this experiment confirm the relationship between the amount of phenolics and biological activities.

Peel oil of Citrus nobilis (Lour) was analyzed for determining its chemical composition. Fourteen identified components accounted for 99.1% (GC) and 100.0% (FID) of the total oil. Major component of the oil was limonene (76.8%-GC and 86.2%-FID). Essential oil was also evaluated for its antioxidant activity in four complementary test systems namely; β-carotene/linoleic acid, DPPH radical scavenging, reducing power and metal chelating activities. In the first system, antioxidant activity increased with the increasing concentration. At 20.0 mg.ml −1 concentration, antioxidant property of the oil was 96.8% ± 0.2 and as strong as the positive controls BHT and α-tocopherol. Scavenging effect of the oil was superior to the positive controls BHT and α-tocopherol at 1.5 mg.ml −1 concentration (96.4% ± 0.1). Reducing power and chelating effect of the essential oil increased with the increasing concentration.

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