Systemic cytokine profile in children with community-acquired pneumonia
Systemic cytokine profile in children with community-acquired pneumonia
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DOI：
10.1002/ppul.20633
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发表时间：
2007-07-01
影响因子：
3.1
通讯作者：
Hardy, R. Doug
中科院分区：
文献类型：
--
作者：
Michelow, Ian C.;Katz, Kathy;Hardy, R. Doug
目的：对社区获得性肺炎（CAP）的全身细胞因子反应进行表征，可能有助于我们了解宿主免疫反应，并提供预后和诊断工具。成人CAP的系统性细胞因子表征主要局限于几个整体细胞因子。方法：分析扩大的血清细胞因子谱与小儿CAP的病因、表现和结局之间是否存在显著关系。我们对55例具有明确特征的CAP住院儿童的15种细胞因子的血清浓度进行了调查。比较由肺炎支原体或肺炎衣原体、肺炎链球菌、病毒、混合感染或不明病原体引起的CAP患者中位细胞因子浓度，发现ifn - α、IL-6、IL-17、GM-CSE和tnf - α浓度存在显著差异。混合感染组ifn - α、IL-6、GM-CSF和tnf - α浓度显著升高。IL-6浓度与疾病严重程度标志物（白细胞带型、降钙素原和明确实变）之间存在显著相关性。没有单一的细胞因子可以可靠地区分肺炎的病因。结论：IL-6是研究的15种血清细胞因子中唯一与儿童CAP疾病严重程度指标相关的一种。细胞因子谱在识别肺炎微生物病因方面的适用性仍有待确定。
Objectives: Characterization of the systemic cytokine response in community-acquired pneumonia (CAP) may facilitate our understanding of the host immune response and provide a prognostic as well as diagnostic tool. Systemic cytokine characterization of CAP has been limited largely to a few integral cytokines in adults. Methods: Analyses were performed to investigate whether significant relationships existed between an expanded serum cytokine profile and etiologies, manifestations, and outcomes of pediatric CAP The serum concentrations of 15 cytokines were investigated in 55 hospitalized children with well-characterized CAP Results: Comparison of median cytokine concentrations among patients with CAP caused by Mycoplasma pneumoniae or Chlamydophila pneumoniae, Streptococcus pneumoniae, viruses, mixed infections, or unidentified pathogens revealed significant differences in IFN-alpha, IL-6, IL-17, GM-CSE and TNF-alpha concentrations. The mixed infections category had significantly elevated concentrations of IFN-alpha, IL-6, GM-CSF, and TNF-alpha. There were significant correlations between concentrations of IL-6 and markers of disease severity (white blood cell band-forms, procalcitonin, and unequivocal consolidation). No single cytokine could reliably differentiate the etiologic cause of pneumonia. Conclusions: IL-6 is the only one of 15 serum cytokines studied that correlated with indicators of disease severity in childhood CAP The applicability of cytokine profiles to identify microbiologic etiologies of pneumonia remains to be defined.