title: Cytokine Concentrations in Plasma from Children with Severe and Non-Severe Community Acquired Pneumonia.
abstract: BACKGROUND
  Children in low and middle-income countries have a high burden of pneumonia. Measuring the cytokine responses may be useful to identify novel markers for diagnosing, monitoring, and treating pneumonia.
  
  
  OBJECTIVE
  To describe and compare a wide range of inflammatory mediators in plasma from children with WHO-defined severe and non-severe community acquired pneumonia (CAP), and explore to what extent certain mediators are associated with severity and viral detection.
  
  
  METHODS
  We collected blood samples from 430 children with severe (n = 43) and non-severe (n = 387) CAP. Plasma from these children were analysed for 27 different cytokines, and we measured the association with age, disease severity and viral detection.
  
  
  RESULTS
  There were generally higher plasma concentrations of several cytokines with both pro-inflammatory and anti-inflammatory effects among children with severe CAP than in children with non-severe CAP. We found significantly higher concentrations of interleukin (IL)-1, IL-4, IL-6, IL-8, IL-9, IL-15, eotaxin, basic fibroblast growth factor (b-FGF), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor-alpha (TNF-α) in the group of severe CAP. Most of these associations persisted when adjusting for age in linear regression analyses. The cytokine response was strongly associated with age but to a lesser extent with viral etiology.
  
  
  CONCLUSIONS
  The plasma concentrations of several cytokines, both with pro-inflammatory and anti-inflammatory effects, were higher among children with severe illness. In particular G-CSF and IL-6 reflected severity and might provide complementary information on the severity of the infection.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00148733.
authors.affiliation: Department of Medical Microbiology, Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Johanne
authors.initials: J
authors.lastname: Haugen
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Ram K
authors.initials: RK
authors.lastname: Chandyo
authors.affiliation: Broegelmann Research Laboratory, Dept. of Clinical Sciences, University of Bergen, Bergen, Norway.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Brokstad
authors.affiliation: University hospital of Northern Norway, Tromsø, Norway.
authors.forename: Maria
authors.initials: M
authors.lastname: Mathisen
authors.affiliation: Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Manjeswori
authors.initials: M
authors.lastname: Ulak
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Sudha
authors.initials: S
authors.lastname: Basnet
authors.affiliation: Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Palle
authors.initials: P
authors.lastname: Valentiner-Branth
authors.affiliation: Department of Medical Microbiology, Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Tor A
authors.initials: TA
authors.lastname: Strand
mesh_terms: D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D008297:Male; D011014:Pneumonia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; D007378:Interleukins