IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients

Abstract

Community-acquired pneumonia (CAP) is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II). The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and homocystein were collected at the time of admission (day 1) as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1) to 8 pg/mL (day 7) (P=0.016). The median levels of TNF-α were higher in patients: i) with acute kidney injury (AKI) (P=0.045), ii) requiring mechanical ventilation (P=0.040), iii) with short hospital stays (P=0.009), iv) admitted to the intensive care unit (ICU) (P=0.040), v) who died early (P=0.003), and vi) with worse CRB scores (P=0.013). In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI.

Discovery and Predictive Modeling of Urine Microbiome, Metabolite and Cytokine Biomarkers in Hospitalized Patients with Community Acquired Pneumonia

“…When we merge two bacterial groups ( Table 9), we found that one can distinguish between healthy, influenza and bacterial categories with very high accuracy of In several studies IL-6 levels in the serum have been found to correlate with either bacterial infections or disease severity in patients with CAP. [44][45][46][47] Our results also detected increased IL-6 in the urine which was elevated in all pneumonias compared to healthy controls. However, based on the predictive modeling, IL-15 and IL-18 in combination with the metabolome and microbiome data may be more useful for distinguishing bacterial vs viral pneumonias.…”

Interleukin-5, interleukin-6, interferon induced protein-10, procalcitonin and C-reactive protein among mechanically ventilated severe community-acquired viral and bacterial pneumonia patients

“…In general, high IL-6 concentrations in serum and bronchoalveolar lavage fluid have been reported in all pneumonia patients. In addition, high serum IL-6 levels correlate to the presence of pneumonia, disease severity, and poor outcome [10,12,[23][24][25]. In an earlier CAP study with 685 patients of whom 3% required mechanical ventilation and 2.7% with septic shock showed that bacteremic patients had higher serum IL-6 levels compared to CAP patients with an unknown microbial etiology [26].…”

Poverty as an independent risk factor for in-hospital mortality in community-acquired pneumonia: A study in a developing country population

“…Although these three scores perform equally well among patients with CAP to predict mortality, CURB‐65 is easier to implement in clinical practice . In some studies CURB‐65 score was not found as a good predictor of adverse outcome or early mortality in CAP. However, according to many other studies, patients with a higher CURB‐65 score had a greater chance for in‐hospital mortality and 30‐day mortality because of pneumonia.…”