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307 , E24E33 (2014)

2014;111:E3297E3305

Rotating sites and injecting slowly often reduce symptoms

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[25] Immune system Immune dysregulation Natural killer cell function is reduced [26] [27] Cytokine dysregulation [28] [29] [30] Elevated regulatory T cells [31] increased mast cell populations [32] elevated anti-cholinergic muscarinic, -adrenergic, [33] phosphatidylinositol [34] and serotonin [35] autoantibodies Reduced CD4+ function [36] and reduced CD4+ count [37] Reduced CD8+ function [36] and reduced CD8+ count [37] Lowered CD4+/CD8+ ratio [38] Increased proportions of effector memory CD8 + T cells [39] (these are rapid responders) Decreased proportions of terminally differentiated effector CD8 + T cells [39] (these kill infected or cancerous cells) Significantly increased proportion of mucosal associated invariant T cells (MAIT) cells (these cells control infections to stop from spreading), especially in severely affected patients [39] Chronic infection Enterovirus: Persistence of enteroviruses in muscle tissue