title: Contribution of Reduced Interleukin-10 Levels to the Pathogenesis of Osteomyelitis in Children with Sickle Cell Disease.
abstract: Osteomyelitis is a significant complication of sickle cell disease (SCD), and several factors contribute to its pathogenesis, including altered expression of proinflammatory and anti-inflammatory cytokines. In view of the role of interleukin-10 (IL-10) as an anti-inflammatory cytokine, we tested the notion that SCD osteomyelitis is associated with a reduction in IL-10 secretion and, hence, precipitation of a proinflammatory state. Study subjects comprised 52 SCD patients with confirmed diagnosis of osteomyelitis and 165 age- and gender-matched SCD patients with negative histories of osteomyelitis. Results obtained showed that IL-10 serum levels in SCD osteomyelitis patients were significantly lower than those of control SCD patients. Receiver operating characteristic (ROC) analysis demonstrated that altered IL-10 serum levels predicted the development of osteomyelitis, and the mean area under ROC curves of IL-10 was 0.810 among SCD patients with osteomyelitis. A systematic shift in IL-10 serum levels toward lower values was seen in osteomyelitis cases, with an increased osteomyelitis risk associated with decreased IL-10 levels. Multivariate logistic regression analyses confirmed the independent association of reduced IL-10 with osteomyelitis after controlling for sickle hemoglobin (HbS), fetal hemoglobin (HbF), platelet count, and white blood cell (WBC) count. These data support the strong association of decreased IL-10 levels with osteomyelitis, thereby supporting a role for IL-10 in osteomyelitis follow-up.
authors.affiliation: College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain samehmss@agu.edu.bh.
authors.forename: Sameh
authors.initials: S
authors.lastname: Sarray
authors.affiliation: College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain.
authors.forename: Wassim Y
authors.initials: WY
authors.lastname: Almawi
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D016207:Cytokines / Q000097:blood / Q000276:immunology; D005260:Female; D005319:Fetal Hemoglobin; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D010019:Osteomyelitis / Q000209:etiology* / Q000276:immunology*; D012372:ROC Curve; D012044:Regression Analysis
chemical_list: D016207:Cytokines; C508609:IL10 protein, human; D016753:Interleukin-10; D005319:Fetal Hemoglobin