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Effects of Deccan volcanism on paleoenvironment and planktic foraminifera: A Online First Geological Society of America Special Papers E-mail alerting services this article to receive free e-mail alerts when new articles cite www.gsapubs.org/cgi/alerts click Subscribe Special Papers to subscribe to Geological Society of America www.gsapubs.org/subscriptions click Permission request to contact GSA. www.geosociety.org/pubs/copyrt.htm#gsa click viewpoint. Opinions presented in this publication do not reflect official positions of the Society. positions by scientists worldwide, regardless of their race, citizenship, gender, religion, or political article's full citation. GSA provides this and other forums for the presentation of diverse opinions and articles on their own or their organization's Web site providing the posting includes a reference to the science. This file may not be posted to any Web site, but authors may post the abstracts only of their unlimited copies of items in GSA's journals for noncommercial use in classrooms to further education and to use a single figure, a single table, and/or a brief paragraph of text in subsequent works and to make GSA, employment. Individual scientists are hereby granted permission, without fees or further requests to

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BackgroundSevere disease caused by 2009 pandemic influenza A/H1N1virus is characterized by the presence of hypercytokinemia. The origin of the exacerbated cytokine response is unclear. As observed previously, uncontrolled influenza virus replication could strongly influence cytokine production. The objective of the present study was to evaluate the relationship between host cytokine responses and viral levels in pandemic influenza critically ill patients.MethodsTwenty three patients admitted to the ICU with primary viral pneumonia were included in this study. A quantitative PCR based method targeting the M1 influenza gene was developed to quantify pharyngeal viral load. In addition, by using a multiplex based assay, we systematically evaluated host cytokine responses to the viral infection at admission to the ICU. Correlation studies between cytokine levels and viral load were done by calculating the Spearman correlation coefficient.ResultsFifteen patients needed of intubation and ventilation, while eight did not need of mechanical ventilation during ICU hospitalization. Viral load in pharyngeal swabs was 300 fold higher in the group of patients with the worst respiratory condition at admission to the ICU. Pharyngeal viral load directly correlated with plasma levels of the pro-inflammatory cytokines IL-6, IL-12p70, IFN-γ, the chemotactic factors MIP-1β, GM-CSF, the angiogenic mediator VEGF and also of the immuno-modulatory cytokine IL-1ra (p < 0.05). Correlation studies demonstrated also the existence of a significant positive association between the levels of these mediators, evidencing that they are simultaneously regulated in response to the virus.ConclusionsSevere respiratory disease caused by the 2009 pandemic influenza virus is characterized by the existence of a direct association between viral replication and host cytokine response, revealing a potential pathogenic link with the severe disease caused by other influenza subtypes such as H5N1.