Contribution of Reduced Interleukin-10 Levels to the Pathogenesis of Osteomyelitis in Children with Sickle Cell Disease

Abstract

Osteomyelitis is a significant complication of sickle cell disease (SCD), and several factors contribute to its pathogenesis, including altered expression of proinflammatory and anti-inflammatory cytokines. In view of the role of interleukin-10 (IL-10) as an anti-inflammatory cytokine, we tested the notion that SCD osteomyelitis is associated with a reduction in IL-10 secretion and, hence, precipitation of a proinflammatory state. Study subjects comprised 52 SCD patients with confirmed diagnosis of osteomyelitis and 165 age-and gender-matched SCD patients with negative histories of osteomyelitis. Results obtained showed that IL-10 serum levels in SCD osteomyelitis patients were significantly lower than those of control SCD patients. Receiver operating characteristic (ROC) analysis demonstrated that altered IL-10 serum levels predicted the development of osteomyelitis, and the mean area under ROC curves of IL-10 was 0.810 among SCD patients with osteomyelitis. A systematic shift in IL-10 serum levels toward lower values was seen in osteomyelitis cases, with an increased osteomyelitis risk associated with decreased IL-10 levels. Multivariate logistic regression analyses confirmed the independent association of reduced IL-10 with osteomyelitis after controlling for sickle hemoglobin (HbS), fetal hemoglobin (HbF), platelet count, and white blood cell (WBC) count. These data support the strong association of decreased IL-10 levels with osteomyelitis, thereby supporting a role for IL-10 in osteomyelitis follow-up.

Interleukin-10 haplotypes are not associated with acute cerebral ischemia or high-risk transcranial Doppler in a newborn cohort of 395 children with sickle cell anemia

“…However, this finding differs from previous published studies, associating low IL-10 levels with vaso-occlusive crises, 16 osteomyelitis, 31 and acute chest syndrome 29 in patients with SCA. Furthermore, this contradicts a previous study showing that a lower serum IL-10 level is associated with ischemic stroke in the general population 32 …”

“…Although not statistically significant, survival analysis ( Figure 2 ) suggested a trend toward acute cerebral ischemia protection in children carrying the haplotypes linked with low IL10 expression. However, this finding differs from previous published studies, associating low IL-10 levels with vaso-occlusive crises, 16 osteomyelitis, 31 and acute chest syndrome 29 in patients with SCA. Furthermore, this contradicts a previous study showing that a lower serum IL-10 level is associated with ischemic stroke in the general population.…”

Th1 and Th2 Cytokines Pattern among Sickle Cell Disease Patients in Côte d’ivoire

“…Conflicting reports are reported on the role of IL-10 in SCD patients. Sarray [21] demonstrated that changes in IL-10 serum levels is predicting VOC in SCD patients and his results clearly demonstrated a significant association between reduced IL-10 levels and the development of VOC and its severity. Patients undergoing Hydroxyurea therapy had high levels of IL-10 [10].…”

The challenge of differentiating vaso-occlusive crises from osteomyelitis in children with sickle cell disease and bone pain: A 15-year retrospective review

“…Decreased IL-10 values have been associated with an increased risk of OM since lower levels of the anti-inflammatory cytokine were reportedly noted in affected patients. 37 Future prospective studies could elaborate further on the link between IL-10 and OM in SCD and explore its role in OM diagnosis and follow-up.…”