title: Increased lung neutrophil apoptosis and inflammation resolution in nonresponding pneumonia.
abstract: Neutrophil activation state and its relationship with an inflammatory environment in community-acquired pneumonia (CAP) remain insufficiently elucidated. We aimed to evaluate the neutrophil apoptosis and cytokine pattern in CAP patients after 72 h of treatment, and their impact on infection resolution. Apoptosis of blood and bronchoalveolar lavage (BAL) neutrophils was measured in nonresponding CAP (NCAP), in responding CAP (blood only) and in patients without infection (control). Pro-inflammatory (interleukin (IL)-6, IL-8) and anti-inflammatory (IL-10) cytokines were measured. Main outcomes were clinical stability and days of hospitalisation. Basal neutrophil apoptosis was higher in the BAL and blood of NCAP, whereas spontaneous apoptosis (after 24 h culture) was lower. Cytokines in NCAP were higher than in responding CAP and control: IL-6 was increased in BAL and blood, IL-8 in BAL and IL-10 in blood. An increased basal apoptosis (≥20%) in BAL of NCAP was associated with lower systemic IL-10 (p<0.01), earlier clinical stability (p=0.05) and shorter hospital stay (p=0.02). A significant correlation was found for systemic IL-6 and IL-10 with days to reach stability and length of stay. After 72 h of treatment, an increased basal alveolar neutrophil apoptosis might contribute to downregulation of inflammation and to faster clinical stability.
authors: Pharmacology Dept, School of Medicine, University and Politecnic Hospital La Fe, Bulevar Sur, 46026 Valencia, Spain.
authors: I
authors: I
authors: Moret
authors: M J
authors: MJ
authors: Lorenzo
authors: B
authors: B
authors: Sarria
authors: E
authors: E
authors: Cases
authors: E
authors: E
authors: Morcillo
authors: M
authors: M
authors: Perpiñá
authors: J M
authors: JM
authors: Molina
authors: R
authors: R
authors: Menéndez
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017209:Apoptosis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D017714:Community-Acquired Infections; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000502:physiology*; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10