Comperison of “Old” and “New” Acute Phase Reactants in Patients With Community Acquired Pneumonia and Diabets Mellitus 2 Type as Inflammatory Changes Markers

Abstract

The aim of the study was to evaluate “old” (WBC count) and “new” inflammatory biomarkers in hospitalized patients with non-severe community-acquired pneumonia in patients with\without Diabetes Mellitus 2 type. Materials and methods. At inclusion, clinical and laboratory parameters of pneumonia were recorded and the CRB-65 was evaluated. A total of 131 adult patients hospitalized with non-severe CAP were included in this prospective study. Levels of pro-inflammatory (IL-1β, IL-8, TNF-α), anti-inflammatory (IL-10) cytokines and markers of inflammation (CRP, complete blood count) were determined at the beginning of the disease (day O) and in 48-72 hours. Results. The level of leukocytes in CBC was significantly higher in the main group at the beginning of the disease, as well after 10 ± 2 days from day 0 the number of episodes of leukocytosis > 10 · 109 / l was higher (8.5% vs. 2%, respectively, p <0,05). There was no statistically significant difference between the studied inflammatory biomarkers levels in the both groups of patients with and without concomitant diabetes. There was a tendency to a higher number of cases of "recovery" after CAP in the group with CRP levels during hospitalization ≥ 21.8 pg / ml (22% vs. 48%, p <0.1). Conclusion. It can be assumed that such a low dynamics of inflammatory markers is associated with involutive changes in the immune system due to older age of the patients included in the study and the influence of DM on the immune system reactivity in the CAP with concomitant DM 2 type with immune response suppression can also explain absence of significant difference in inflammatory biomarkers concentration in the groups compered in this study.