Abstract
Background: Limited literature suggests that cytokines/chemokines in childhood pneumonia could be potential biomarkers of disease severity, etiology or outcome.
Objective: To measure a panel of cytokines/chemokines in children with community acquired pneumonia at presentation, and evaluate their relationship to etiology, clinical severity, total leukocyte count, chest radiography, and outcome.
Methods: We enrolled 222 consecutive children (1mo-12y) with severe (SP) and very severe pneumonia (VSP) as per WHO IMCI definition. All underwent chest radiography, blood culture and nasopharyngeal aspirate (NPA) culture. NPA samples were examined for respiratory viruses by multiplex PCR. The cytokines interferon-gamma, IL-1b, IL-4, IL-6, IL-8 and CCL-22 were measured in serum using Luminex.
Results: Etiology was bacterial in 60, viral in 71, atypical organisms in 5, and indeterminate/mixed in 86 cases. None of the cytokines showed any differences in terms of bacterial vs viral etiology or normal vs high leukocyte count. IL-6 was significantly lower in children with radiographic consolidation (1291.39 vs 1774.41pg/ml) and those with fatal outcome (6144.67 vs 8350.75pg/ml). IL-6 was higher in children classified with SP than VSP (2477.03 vs 2430.80pg/ml). IL-8 was significantly lower in those with radiographic consolidation (1647.33 vs 3039.5 pg/ml).
Conclusions: The pro-inflammatory cytokine IL-6 was higher in children with SP (compared to VSP) and those who survived. This suggests that VSP and fatal outcome may be associated with a dysregulated inflammatory response. However, our data indicate that these cytokines cannot be used as reliable predictive biomarkers for microbial etiology.
- Copyright ©the authors 2016
