title: Alterations of serum cytokine levels and their relation with inflammatory markers in candidemia.
abstract: The roles of CRP, PCT, serum amyloid A (SAA), and cytokines in the diagnosis of fungal infections have not yet been clearly demonstrated. This study aims to measure the serum levels of interleukin (IL)-23, IL-17, IL-1β, tumor necrosis factor (TNF)-α, IL-10, transforming growth factor (TGF)-β, C-reactive protein (CRP), procalcitonin (PCT), and serum amyloid A (SAA) in cases of candidemia and to compare them with those observed in cases of bacteremia. For this purpose, the serum cytokine levels from 50 patients with candidemia were compared with those of 14 patients with polymicrobial sepsis, 30 patients with bacteremia, and 27 healthy control subjects. The cytokine levels were studied using sandwich ELISAs according to the manufacturer protocol. The serum levels of TGF-β, IL-23, and IL-17 were found to be significantly higher in the candidemia group in comparison with the samples from those with bacteremia and healthy controls. The PCT and SAA levels were higher in samples from the group with bacteremia those from individuals with candidemia and the healthy control group. Assuming an IL-17 level threshold of >38.79 pg/ml, the sensitivity and specificity were 38% and 96.6%, respectively but considering an IL-23 threshold of >59.97 pg/ml, the sensitivity and specificity values were found to be 72% and 60%, respectively. The sensitivity and the specificity of the TGF-ß levels were found to be 85.71% and 53.33%, respectively, when the TGF-ß threshold is >560 pg/ml. PCT and SAA demonstrated a superior performance for the differentiation of candidemia and bacteremia. Our study demonstrates that IL-17, IL-23, TGF-ß, PCT, and SAA levels could be a diagnostic marker for candidemia.
authors: Specialist in Infectious Diseases and Clinical Microbiology, Uludag University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, 16059, Bursa-Turkey.
authors: Hicran
authors: H
authors: Akin
authors: Professor in Infectious Diseases and Clinical Microbiology, Uludag University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, 16059, Bursa-Turkey halis@uludag.edu.tr.
authors: Halis
authors: H
authors: Akalin
authors: Associate Professor in Immunology, Uludag University, Faculty of Medicine, Department. of Immunology, 16059, Bursa-Turkey.
authors: Ferah
authors: F
authors: Budak
authors: Professor in Medical Mycology and Microbiology, Uludag University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, 16059, Bursa-Turkey.
authors: Beyza
authors: B
authors: Ener
authors: Specialist in Biostatistics, Uludag University, Faculty of Medicine, Department of Biostatistics, 16059, Bursa-Turkey.
authors: Gökhan
authors: G
authors: Ocakoğlu
authors: Specialist in Infectious Diseases and Clinical Microbiology, Doruk Private Hospital, Bursa-Turkey.
authors: Emel
authors: E
authors: Gürcüoğlu
authors: Professor in Medical Microbiology, Uludag University, Faculty of Medicine, Department of Microbiology and Clinical Microbiology, 16059, Bursa-Turkey.
authors: Güher
authors: G
authors: Göral
authors: Professor in Immunology, Uludag University, Faculty of Medicine, Department of Immunology, 16059, Bursa-Turkey.
authors: Haluk Barbaros
authors: HB
authors: Oral
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000473:pathology; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D058387:Candidemia / Q000473:pathology*; D060085:Coinfection / Q000473:pathology; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D000685:Serum Amyloid A Protein / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D016207:Cytokines; D011498:Protein Precursors; D000685:Serum Amyloid A Protein; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: IL-17; IL-23; PCT; candidemia; sepsis