title: The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia.
abstract: To identify markers for earlier diagnosis of severe pneumonia, we assess the correlation between serum cytokine profile of children with different pneumonia severity.
  
  
  
  In 25 hospitalized children, 7 with mild pneumonia and 18 with severe pneumonia, the serum concentration of 11 cytokines in three sampling times were dosed. Statistical analysis included parametric and non-parametric tests, Pearson correlation and ROC curve for cut-off definition of cytokines.
  
  
  
  At admission, IL-6 serum levels were high in mild or severe pneumonia, and was associated to vomiting (P = 0.019) in both groups; and also to dyspnea (P = 0.012) and white blood cell count (P = 0.045) in patients with severe pneumonia. IL-10 levels were also high in patients with pneumonia and were associated to lymphocytosis (P = 0.025). The ROC curve of the IL-6:IL-10 serum levels ratio discriminated severe pneumonia cases at admission, and persistence of infection in the third day of antibiotic therapy, with positive predictive values of 93% and 89%, respectively.
  
  
  
  The balance between IL-6 and IL-10 serum levels showed to be a more discriminative marker for severity definition and evaluation of recovery in patients with pneumonia.
authors.affiliation: Institute of Integral Medicine Professor Fernando, Figueira (IMIP), Pediatrics, Rua Dona Benvinda de Farias 159, apt 1101, Boa Viagem, Recife, Pernambuco, Brazil. moraesdebrito@gmail.com.
authors.forename: Rita de Cássia Coelho Moraes
authors.initials: RC
authors.lastname: de Brito
authors.affiliation: Institute of Integral Medicine Professor Fernando Figueira (IMIP), Oncology and Aggeu Magalhães Research Center, Fiocruz-PE, Immunology, Recife, Brazil.
authors.forename: Norma
authors.identifier: 0000-0002-6140-1794
authors.initials: N
authors.lastname: Lucena-Silva
authors.affiliation: Institute of Integral Medicine Professor Fernando, Figueira, IMIP, Translational Medicine Laboratory, Recife, Brazil.
authors.forename: Leuridan Cavalcante
authors.initials: LC
authors.lastname: Torres
authors.affiliation: Aggeu Magalhães Research Center, Fiocruz-PE, Public Health, Recife, Brazil.
authors.forename: Carlos Feitosa
authors.initials: CF
authors.lastname: Luna
authors.affiliation: Institute of Integral Medicine Professor Fernando, Figueira, IMIP, Translational Medicine Laboratory, Recife, Brazil.
authors.forename: Jaílson de Barros
authors.initials: JB
authors.lastname: Correia
authors.affiliation: Federal University of Pernambuco, Pediatrics, Recife, Brazil.
authors.forename: Giselia Alves Pontes
authors.initials: GA
authors.lastname: da Silva
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D011014:Pneumonia / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016753:Interleukin-10
keywords: Cytokines; Immune response; Inflammation; Pneumonia