Role of interleukin-18 and T-helper type 1 cytokines in the development of Mycoplasma pneumoniae pneumonia in adults
Role of interleukin-18 and T-helper type 1 cytokines in the development of Mycoplasma pneumoniae pneumonia in adults
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DOI：
10.1378/chest.121.5.1493
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发表时间：
2002-05-01
期刊：
影响因子：
9.6
通讯作者：
Abe, S
中科院分区：
文献类型：
--
作者：
Tanaka, H;Narita, M;Abe, S
研究目的：白细胞介素（IL）-18是一种促炎细胞因子，最初称为干扰素（IFN）-γ诱导因子;其促进T辅助细胞1型（Th 1）细胞因子应答。我们最近报道肺炎支原体肺炎（NIP）患儿血清IL-18水平升高。在这项研究中，我们调查了IL-18对感染的贡献，并评估了Th 1细胞因子对成人肺部受累的反应。方法：我们调查了21例急性期MP患者和21例年龄和性别匹配的对照组的临床病程、肺部受累和血清IL-18、IFN-γ、IL-12 p40和可溶性IL-2受体（sIL-2 R）水平。显著（p < 0.001）血清IL-18增加（中位数，248 pg/mL [范围，89 - 441 pg/mL] vs中位数，126 pg/mL [范围，47 - 217 pg/mL]）和sIL-2 R（中位数，617 U/mL [范围，410 - 1，032 U/mL] vs中位数，425 U/mL [范围，268 - 601 U/mL]），血清IFN-γ和IL-12 p40有升高的趋势。循环IL-18值与血清sIL-2 R水平（r = 0.62，p = 0.028）和受累肺叶数量（OR = 0.61，p = 0.024）呈正相关，但与血清肺炎支原体抗体、IFN-γ或IL-12 p40水平无关。重症患者血清IL-18和sIL-2 R水平显著高于轻症患者（P < 0.03）。4例胸腔积液患者血清IFN-γ和sIL-2 R水平显著高于其他17例患者（P < 0.05）。提示IL-18和Th 1细胞因子可能在MP的免疫病理反应中起重要作用。
Study objective: Interleukin (IL)-18 is a proinflammatory cytokine, originally termed interferon (IFN)-gamma-inducing factor; which promotes T-helper type 1 (Th1) cytokine responses. We recently reported that serum IL-18 levels were elevated in children with Mycoplasma pneumoniae pneumonia (NIP). In this study, we investigated the contribution of IL-18 to the infection and assessed the Th1 cytokine response to pulmonary involvement in adults.Methods: We investigated the clinical course, pulmonary involvement, and serum levels of IL-18, IFN-gamma, IL-12p40, and soluble IL-2 receptor (sIL-2R) in 21 patients with acute-stage MP and in 21 age- and sex-matched control subjects.Results: Significantly (p < 0.001) increased serum IL-18 (median, 248 pg/mL [range, 89 to 441 pg/mL] vs median, 126 pg/mL [range, 47 to 217 pg/mL]) and sIL-2R (median, 617 U/mL [range, 410 to 1,032 U/mL] vs median, 425 U/mL [range, 268 to 601 U/mL]) were found in patients with MP as compared with healthy control subjects, and there was a tendency toward increased serum IFN-γ and IL-12p40. Circulating IL-18 values had a positive correlation with serum sIL-2R levels (r = 0.62, p = 0.028) and the number of affected pulmonary lobes (or = 0.61, p = 0.024), but not with the serum levels of antibodies to M pneumoniae, IFN-γ, or IL-12p40. Serum IL-18 and sIL-2R values in severe cases were significantly higher (p < 0.03) than those in mild cases. IFN-gamma and sIL-2R levels in four patients with pleural effusion were significantly (p < 0.05) higher than those in the other 17 subjects.Conclusions: Serum levels of IL-18 were raised during the acute phase of MP. We suggest IL-18 and Th1 cytokines may play a significant role in the immunopathologic responses in MP.