CYTOKINES PROFILE AND ITS CONNECTION WITH DISEASE SEVERITY IN COMMUNITY-ACQUIRED PEDIATRIC PNEUMONIA

Community-acquired pneumonia is (CAP) associated with serious complications and is the leading cause of death in children. Severity of CAP is depend on an impairment of host defenses. Persistent and toxic inflammation directs to an excessively pro-inflammatory cytokine production, neutrophil hyper-responsiveness, and dysregulation of lung neutrophil apoptosis, which results in lung injury and poor patient outcomes. However, the correlation between increased cytokine levels and clinical outcome in children remains unclear. The main aim of present work was evaluation the potential association serum cytokine levels with complications and severity of pneumonia and identification marker for earlier diagnosis of pneumonia complications. For this purposes, 62 children admitted to Iashvili Central Children Hospital during 2013-2014, Tbilisi, Georgia, were investigated. The study was approved by the Ethics Committee of the Tbilisi State Medical University and written informed consent was obtained from the parents/legal guardians of all study participants. Control group consisted of 10 healthy age matched individuals. All samples (serum, urine, sputum, nasopharyngeal swabs) were analyzed for the presence of respiratory viruses and/or bacterial pathogens. The serum cytokines (IFN-gamma, TNF-alfa, IL-8, IL-10) levels were determined by enzyme-linked immunosorbent assay (ELISA) on the first and fifth day of hospitalization. The patients with community-acquired pneumonia on the first and fifth day of the treatment had significantly higher cytokine concentrations (IFN-g, TNF-a, IL-8, IL-10) than age matched individuals (p<0.01). Moreover, IL-10 and TNF-a (p<0.05) levels were statistical differ between groups with high and low saturation, However, patients with pleural effusion have significantly lower circulating IL- 8, than without effusion. Based on our results, circulatory cytokines (IL-10, TNF, IL-8) were elevated in CAP patient and can be used as markers of pneumonia severity signs (saturation, pleural effusion etc). However more studies are needed for before using cytokines as indicator of disease prognosis.