Interleukin-18 binding protein in infants and children hospitalized with pneumonia in low-resource settings

Area of Science:

• Pediatric Infectious Diseases
• Immunology
• Biomarker Discovery

Background:

• Pneumonia is a leading infectious cause of child mortality, particularly in low- and middle-income countries.
• Interleukin-18 binding protein (IL-18BP), a natural antagonist of interleukin-18, is elevated in various inflammatory and infectious conditions.

Purpose of the Study:

• To investigate the association between admission IL-18BP levels and clinical severity in Ugandan children hospitalized with hypoxemic pneumonia.
• To explore the correlation of IL-18BP levels with indicators of disease severity and recovery time.

Main Methods:

• A prospective cohort study was conducted with 42 children admitted for hypoxemic pneumonia.
• IL-18BP levels were measured at admission and correlated with clinical signs of respiratory distress, the Pediatric Early Death Index for Africa (PEDIA-e) score, and time to clinical recovery milestones.

Main Results:

• Elevated IL-18BP levels were significantly associated with respiratory distress, including chest indrawing and nasal flaring (P < 0.05).
• IL-18BP levels showed a positive correlation with the composite clinical severity score (PEDIA-e, ρ = 0.46, P = 0.0020).
• Children with higher IL-18BP levels (>14 ng/mL) experienced significantly longer times to sit and to fever resolution (P < 0.05).

Conclusions:

• Higher admission IL-18BP levels in Ugandan children with pneumonia are linked to increased disease severity.
• IL-18BP may serve as a valuable biomarker for assessing pneumonia severity and predicting recovery duration in pediatric populations.
• Further research is warranted to explore the therapeutic implications of targeting the IL-18 pathway in severe pediatric pneumonia.