Diagnostic value of blood cytokine concentrations in acute pneumonia.
BACKGROUND
The role of cytokines in the pathogenesis of pneumonia is still poorly understood. In a previous study the diagnostic value of measuring blood concentrations of interleukin 6 and interferon gamma was established. In the present study the value of blood concentrations of interleukin 8, granulocyte-colony stimulating factor, and lactoferrin as markers of bacteraemic pneumonia is evaluated.


METHODS
The circulating concentrations of interleukin 8 (IL-8), granulocyte-colony stimulating factor (G-CSF), and lactoferrin were measured in 14 patients with bacteraemic pneumococcal pneumonia and 49 patients with atypical pneumonia or influenza A infection using enzyme immunoassays.


RESULTS
Serum G-CSF concentrations were higher in the group with bacteraemic pneumococcal pneumonia, and G-CSF values correlated with the white blood cell count and levels of C-reactive protein (CRP). The levels of IL-8 were higher in the group with bacteraemic pneumococcal pneumonia than the groups with Chlamydia pneumonia, Legionella pneumonia, or influenza A infection, but there was no difference when compared with the group with Mycoplasma pneumonia. A white blood cell count of > 15 x 10(9)/l was highly suggestive of bacteraemic pneumonia. The concentrations of lactoferrin were raised in all groups except those with influenza A infection, but no difference was found between the different aetiological groups. A correlation was found between lactoferrin and white blood cell counts.


CONCLUSIONS
Serum G-CSF and IL-8 concentrations are potential markers of bacteraemic pneumonia.
Kragsbjerg
P
P
Department of Infectious Diseases, Orebro Medical Center Hospital, Sweden.
Jones
I
I
Vikerfors
T
T
Holmberg
H
H
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002690:Chlamydia Infections / Q000175:diagnosis / Q000276:immunology; D016207:Cytokines / Q000097:blood*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D009980:Influenza A virus; D007251:Influenza, Human / Q000175:diagnosis / Q000276:immunology; D016209:Interleukin-8 / Q000097:blood; D007781:Lactoferrin / Q000097:blood; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000276:immunology; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000276:immunology; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000276:immunology
D015415:Biomarkers; D016207:Cytokines; D016209:Interleukin-8; D016179:Granulocyte Colony-Stimulating Factor; D007781:Lactoferrin