Role of interferon regulatory factors in predicting the prognosis of Crimean-Congo hemorrhagic fever

Abstract Objectives Crimean-Congo hemorrhagic fever (CCHF) is a severe viral illness with a high fatality rate. The interferon response plays a crucial role in the antiviral defense against the CCHF virus (CCHFV). Interferon regulatory factors (IRFs) are essential for initiating and amplifying the interferon response. In this study, we aimed to evaluate the IRF response in CCHF patients for the first time. Methods This study investigated the expression levels of various IRFs (IRF-1, 2, 3, 4, and 7) in CCHF patients and evaluated their potential association with disease prognosis. The research encompassed a cohort of 60 CCHF patients and 30 healthy volunteers. CCHF was diagnosed with CCHFV positivity using PCR method and/or IgM detection using ELISA method. The quantitative sandwich ELISA technique was employed to determine the levels of serum IRF-1, IRF-2, IRF-3, IRF-4, IRF-7, interferon (IFN)-alpha, and IFN-beta. Results There were statistically significant differences in the levels of serum IRF-1, IRF-2, IRF-3, IRF-4, IRF-7, IFN-alpha, and IFN-beta between the patient and healthy control groups. Patients showed elevated levels in all these factors except for IRF-1. However, no statistically significant differences were found in IRF-1, IRF-2, IRF-3, IRF-4, IRF-7, IFN-alpha, and IFN-beta levels between patients who survived and those who died. Conclusions IFN-alpha and beta likely contribute to the immune response in CCHF. IRF-2, 3, 4, and 7 play crucial roles in IFN-alpha and beta expression, pivotal for the antiviral response in CCHF. Targeted interventions to modulate IRF-1 could alleviate disease severity and overall impact.