title: Systemic cytokine levels in community-acquired pneumonia and their association with disease severity.
abstract: Pro-inflammatory and anti-inflammatory cytokines are important mediators in the host response to infection. In contrast to the pro-inflammatory cytokines little is known about anti-inflammatory cytokines in community-acquired pneumonia (CAP) and their relation to disease severity. Circulating levels of three pro-inflammatory cytokines (interleukin (IL)-1beta, IL-6 and tumour necrosis factor (TNF)-alpha) and two anti-inflammatory cytokines (IL-10, IL-1 receptor antagonist (IL-1ra)) were measured using an enzyme immunoassay on admission, day 3 and day 5 in 24 patients with CAP. The modified British Thoracic Society (BTS) prognostic rule and Acute Physiology and Chronic Health Evaluation (APACHE) II score were used to assess disease severity. IL-6, TNF-alpha, IL-10 and IL-1ra concentrations were detected in most patients on admission and decreased significantly on day 3 and day 5 in all survivors. A significant difference between the BTS high-risk and low-risk groups was only found for IL-6 (median (range) 477 pg x mL(-1) (7.6-1402 pg x mL(-1)) versus 81.6 pg x mL(-1) (0-943 pg x mL(-1)); p<0.05). IL-6 also correlated with the APACHE II scores on admission. Concentrations of anti-inflammatory cytokines were elevated on admission in community-acquired pneumonia but they did not correlate with disease severity scores.
authors.affiliation: Dept of University Medicine, Southampton General Hospital, UK.
authors.forename: G
authors.initials: G
authors.lastname: Antunes
authors.forename: S A
authors.initials: SA
authors.lastname: Evans
authors.forename: J L
authors.initials: JL
authors.lastname: Lordan
authors.forename: A J
authors.initials: AJ
authors.lastname: Frew
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000097:blood* / Q000175:diagnosis; D016207:Cytokines / Q000097:blood* / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood* / Q000382:microbiology*; D011336:Probability; D011379:Prognosis; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012795:Sialoglycoproteins / Q000097:blood*; D016019:Survival Analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D015415:Biomarkers; D016207:Cytokines; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1; D015850:Interleukin-6; D012795:Sialoglycoproteins; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10