OI: 10.1038/srepwww.nature.com/scientificreports/RDP group (n = 10) Age (years) Estimated infection day at DM-3189 site seroconversion (days) Follow-up (days) Fiebig staging I-II III-IV V-VI Subtype AE BC B Acute symptoms Active syphilis at seroconversion HBV SB 202190 chemical information co-infection HCV co-infection Initial CD4+ T cell counts (cells/L) CD4+ setpoint (cells/L) Peak viral load (Log copies/mL) Plasma viral load setpoint (Log copies/mL) 70 (34.75?.33) 0 (0?0.85) 30 (6.67?5.25) 70 (34.75?3.33) 60 (26.24?7.84) 0 0 350 (242?26.75) 288.2 (147.2?51.3) 5.14 (4.38?.67) 4.94 (4.35?.5) 80 (44.39?7.48) 10 (0.25?4.5) 10 (0.25?4.5) 70 (34.75?3.33) 30 (6.67?5.25) 0 0 665 (591?01.75) 653.6 (555.7?48.0) 4.32 (3.68?.02) 3.47 (2.77?.54) <0.001 <0.001 0.046 0.046 1.000 0.178 0.356 0 (0?0.85) 40 (12.16?3.76) 60 (26.24?7.84) 20 (2.52?5.61) 50 (18.71?1.29) 30 (6.67?5.25) 0.211 26 (24.5?5) 30 (25.75?4.25) 414 (273.5?86.25) SDP group (n = 10) 26.5 (24?0.75) 30 (17.75?2.25) 612 (554?03.75) p value 0.786 0.846 0.Table 1. Baseline characteristics of the HIV-infected participants. Data are (95 CI) or median (IQR), unless otherwise indicated. RDP: Rapid Disease Progressor; SDP: Slow Disease Progressor.We speculate that the "cytokine cascade" and "new order" in this network may be one of the important factors determining HIV-1-mediated immunodeficiency. However, the very early kinetics of cytokines during the first weeks of infection is unknown17?9. To address this deficit, we took advantage of a well-established longitudinal acute HIV-1 cohort (Beijing PRIMO cohort study) to investigate the dynamics of 26 cytokines in plasma from pre-infection to acute and chronic phases of infection20,21.Basic characteristics of the study participants. Twenty acute HIV-infected individuals from an MSM cohort were recruited into this study22. Basic information about 10 rapid disease progressors (RDPs) and 10 slow disease progressors (SDPs) is described in Table 1. Multiple cytokine storms during acute phase of HIV-1 infection. In order to investigate the dynamics of plasma cytokines during HIV infection, sequential longitudinal plasma samples collected from pre-infection to over three years post-infection were analyzed. As shown in Table 2, compared with HIV-negative MSM controls, HIV-infected individuals had significantly increased plasma cytokines between 180 days and 3 years post-infection. Increased cytokines included GM-CSF, IFN-2, IL-12p70, IP-10 and VEGF (p < 0.001), and much higher levels were observed in RDPs compared to those in SDPs. Interestingly, as shown in Fig. 1 (IFN-2, IFN-, IL-12, IL-15, IP-10 and TNF- as a representative) and S1 (other 20 cytokines), during acute stage of infection, plasma cytokines FGF-2, GM-CSF, IFN-2, IFN-, IL-1, IL-1ra, IL-2, IL-6, IL-10, IP-10, IL-12-p70, TNF- and VEGF had more positive changes in RDPs than those in SDP. Considering that the dynamic changes in cytokines might be related to disease progression, we analyzed plasma levels of each cytokine and the time to reach peak value. We found that some cytokines rapidly increased to their highest levels, whereas others took much longer to do so (Table 3). For example, plasma IP-10, IL-8, and MCP-1 in RDPs reached peak value at 30 days post infection, whereas IL-6, GM-CSF, and VEGF were delayed after 60 days post infection in RDPs. More interestingly, RDPs had much earlier and stronger cytokine storms in acute stage, compared with SDPs (49.6 days vs. 74.9 days, respectively; 6.7-fold vs. 3.7-fold change, respectiv.OI: 10.1038/srepwww.nature.com/scientificreports/RDP group (n = 10) Age (years) Estimated infection day at seroconversion (days) Follow-up (days) Fiebig staging I-II III-IV V-VI Subtype AE BC B Acute symptoms Active syphilis at seroconversion HBV co-infection HCV co-infection Initial CD4+ T cell counts (cells/L) CD4+ setpoint (cells/L) Peak viral load (Log copies/mL) Plasma viral load setpoint (Log copies/mL) 70 (34.75?.33) 0 (0?0.85) 30 (6.67?5.25) 70 (34.75?3.33) 60 (26.24?7.84) 0 0 350 (242?26.75) 288.2 (147.2?51.3) 5.14 (4.38?.67) 4.94 (4.35?.5) 80 (44.39?7.48) 10 (0.25?4.5) 10 (0.25?4.5) 70 (34.75?3.33) 30 (6.67?5.25) 0 0 665 (591?01.75) 653.6 (555.7?48.0) 4.32 (3.68?.02) 3.47 (2.77?.54) <0.001 <0.001 0.046 0.046 1.000 0.178 0.356 0 (0?0.85) 40 (12.16?3.76) 60 (26.24?7.84) 20 (2.52?5.61) 50 (18.71?1.29) 30 (6.67?5.25) 0.211 26 (24.5?5) 30 (25.75?4.25) 414 (273.5?86.25) SDP group (n = 10) 26.5 (24?0.75) 30 (17.75?2.25) 612 (554?03.75) p value 0.786 0.846 0.Table 1. Baseline characteristics of the HIV-infected participants. Data are (95 CI) or median (IQR), unless otherwise indicated. RDP: Rapid Disease Progressor; SDP: Slow Disease Progressor.We speculate that the "cytokine cascade" and "new order" in this network may be one of the important factors determining HIV-1-mediated immunodeficiency. However, the very early kinetics of cytokines during the first weeks of infection is unknown17?9. To address this deficit, we took advantage of a well-established longitudinal acute HIV-1 cohort (Beijing PRIMO cohort study) to investigate the dynamics of 26 cytokines in plasma from pre-infection to acute and chronic phases of infection20,21.Basic characteristics of the study participants. Twenty acute HIV-infected individuals from an MSM cohort were recruited into this study22. Basic information about 10 rapid disease progressors (RDPs) and 10 slow disease progressors (SDPs) is described in Table 1. Multiple cytokine storms during acute phase of HIV-1 infection. In order to investigate the dynamics of plasma cytokines during HIV infection, sequential longitudinal plasma samples collected from pre-infection to over three years post-infection were analyzed. As shown in Table 2, compared with HIV-negative MSM controls, HIV-infected individuals had significantly increased plasma cytokines between 180 days and 3 years post-infection. Increased cytokines included GM-CSF, IFN-2, IL-12p70, IP-10 and VEGF (p < 0.001), and much higher levels were observed in RDPs compared to those in SDPs. Interestingly, as shown in Fig. 1 (IFN-2, IFN-, IL-12, IL-15, IP-10 and TNF- as a representative) and S1 (other 20 cytokines), during acute stage of infection, plasma cytokines FGF-2, GM-CSF, IFN-2, IFN-, IL-1, IL-1ra, IL-2, IL-6, IL-10, IP-10, IL-12-p70, TNF- and VEGF had more positive changes in RDPs than those in SDP. Considering that the dynamic changes in cytokines might be related to disease progression, we analyzed plasma levels of each cytokine and the time to reach peak value. We found that some cytokines rapidly increased to their highest levels, whereas others took much longer to do so (Table 3). For example, plasma IP-10, IL-8, and MCP-1 in RDPs reached peak value at 30 days post infection, whereas IL-6, GM-CSF, and VEGF were delayed after 60 days post infection in RDPs. More interestingly, RDPs had much earlier and stronger cytokine storms in acute stage, compared with SDPs (49.6 days vs. 74.9 days, respectively; 6.7-fold vs. 3.7-fold change, respectiv.