title: The severity of Streptococcus pyogenes infections in children is significantly associated with plasma levels of inflammatory cytokines.
abstract: Cytokines are intimately involved with the innate and adaptive immune response to bacterial infections. This study was designed to determine the expression of inflammatory cytokines in children by the severity of Streptococcus pyogenes (group A Streptococcus [GAS]) infections. The study population consisted of 16 invasive, 20 noninvasive, and 24 pharyngeal colonization, and 21 healthy controls. All children underwent the laboratory tests and cytokine measurement. GAS isolates were analyzed for emm gene typing. Patients with invasive GAS diseases had significantly higher interferon (IFN)-gamma, interleukin (IL)-1beta, IL-6, IL-8, IL-10, and IL-18 than those with noninvasive diseases, colonization, and healthy controls. There was no difference in tumor necrosis factor (TNF)-alpha, IL-12, and IL-2 levels among the groups. Elevated white blood cell counts and levels of C-reactive protein and C3 were detected only in patients with invasive diseases. emm1 and emm12 predominated in invasive disease and colonization. Children with invasive GAS infections exhibited significant up-regulation of plasma levels of IFN-gamma, IL-1beta, IL-6, IL-8, IL-10, and IL-18, and suppression of TNF-alpha and IL-12 during the acute phase of their illness. An exuberant cytokine response was associated with the severity of illness.
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
authors.forename: Shih-Min
authors.initials: SM
authors.lastname: Wang
authors.forename: Ih-Hui
authors.initials: IH
authors.lastname: Lu
authors.forename: Ya-Lan
authors.initials: YL
authors.lastname: Lin
authors.forename: Yee-Shin
authors.initials: YS
authors.lastname: Lin
authors.forename: Jiunn-Jong
authors.initials: JJ
authors.lastname: Wu
authors.forename: Woei-Jer
authors.initials: WJ
authors.lastname: Chuang
authors.forename: Ming T
authors.initials: MT
authors.lastname: Lin
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
mesh_terms: D000942:Antigens, Bacterial / Q000235:genetics; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D002097:C-Reactive Protein / Q000032:analysis; D002352:Carrier Proteins / Q000235:genetics; D002353:Carrier State / Q000276:immunology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003176:Complement C3 / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D010949:Plasma / Q000737:chemistry; D013290:Streptococcal Infections / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology*; D013297:Streptococcus pyogenes / Q000145:classification* / Q000276:immunology* / Q000302:isolation & purification
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; D003176:Complement C3; D016207:Cytokines; C014689:streptococcal M protein; D002097:C-Reactive Protein