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Published on: August 7, 2017
Cytokine Concentrations in Plasma from Children with Severe and Non-Severe Community Acquired Pneumonia
Johanne Haugen1, Ram K Chandyo2, Karl A Brokstad3
1Department of Medical Microbiology, Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway.
Insights
Children with severe community-acquired pneumonia (CAP) exhibit elevated levels of various cytokines. Granulocyte colony-stimulating factor (G-CSF) and interleukin-6 (IL-6) show particular promise as severity markers.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Biomarker Discovery
Background:
- Community-acquired pneumonia (CAP) poses a significant health burden on children in low and middle-income countries.
- Cytokine profiling offers potential for identifying novel diagnostic and prognostic markers for pediatric pneumonia.
Purpose of the Study:
- To compare a broad spectrum of inflammatory mediators in children with severe versus non-severe CAP.
- To investigate the association of these mediators with disease severity and viral detection in pediatric CAP.
Main Methods:
- Plasma samples from 430 children with CAP (severe n=43; non-severe n=387) were analyzed for 27 distinct cytokines.
- Associations between cytokine concentrations, age, disease severity, and viral etiology were assessed.
Main Results:
- Children with severe CAP showed higher plasma concentrations of multiple pro-inflammatory and anti-inflammatory cytokines, including IL-1, IL-4, IL-6, IL-8, IL-9, IL-15, eotaxin, b-FGF, G-CSF, GM-CSF, and TNF-α.
- These associations largely remained significant after adjusting for age.
- Cytokine response correlated strongly with age but less so with viral detection.
Conclusions:
- Elevated plasma cytokine levels, encompassing both pro- and anti-inflammatory mediators, are characteristic of severe CAP in children.
- Granulocyte colony-stimulating factor (G-CSF) and interleukin-6 (IL-6) plasma concentrations may serve as valuable complementary indicators of pneumonia severity.
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.
Conclusion:
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.
Trial Registration:
ClinicalTrials.gov NCT00148733.
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