Transcriptomic Analysis Reveals Key Molecular Signatures Across Recovery Phases of Hemorrhagic Fever with Renal Syndrome

Hemorrhagic fever with renal syndrome (HFRS), a life-threatening zoonosis caused by hantavirus, poses significant mortality risks and lacks specific treatments. Here we employed RNA sequencing to analyze the transcriptomic alterations in peripheral blood mononuclear cells from HFRS patients across the oliguric phase (OP), diuretic phase (DP), and convalescent phase (CP). Our analysis revealed pronounced transcriptomic differences between DP and OP, with 38 differentially expressed genes (DEGs) showing consistent expression changes across all phases. Notably, immune checkpoint genes like CD83 and NR4A1 demonstrated a monotonic increase, in contrast to a monotonic decrease observed in antiviral and immunomodulatory genes, including IFI27 and RNASE2. 12 DEGs were validated using quantitative real-time PCR. Furthermore, this research elucidates a sustained attenuation of immune responses following viral infection, alongside an upregulation of pathways related to tissue repair and regeneration. In conclusion, our research reveals the transcriptomic shifts during the recovery phases of HFRS, illuminating key pathways and genes that may serve as markers for disease progression and recovery. Overall design: Nine Peripheral blood samples at different phases were collected from three patients