Patterns of Cytokine Expression in Community-Acquired Pneumonia

Puren, Adrian; Feldman, Charles; Savage, Nerina; Becker, P J; Smith, Clifford A.

doi:10.1378/chest.107.5.1342

Cited by 137 publications

(95 citation statements)

References 29 publications

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“…No acute phase response was observed for IL-5, IL-12, IFN-c, MCP and MIP. Our results are comparable with former findings in human and experimental pneumococcal pneumonia, in which the inflammatory response is characterised by an extended pro-inflammatory response resulting in high levels of IL-6 and IL-1RA [2,10,13,21,[35][36][37]. In this study, cytokines and chemokines were only measured in serum.…”

Section: Community-acquired Pneumonia H Endeman Et Alsupporting

confidence: 92%

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Systemic cytokine response in patients with community-acquired pneumonia

Endeman¹,

Meijvis²,

Rijkers³

et al. 2010

European Respiratory Journal

105

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The role of individual cytokines and polymorphisms in pneumonia has been described, but the relationship between different cytokines and polymorphisms in relation to causative microorganisms, antibiotics, corticosteroids and clinical course has not. This study questions the relationship between cytokines, polymorphisms and clinical characteristics of pneumonia.Patients diagnosed with pneumonia were included in the study. Serum cytokine levels were measured during hospital stay, genotyping was performed, causative microorganisms were identified and patients were monitored throughout the hospital stay.In 201 patients with pneumonia interleukin (IL)-1 receptor antagonist (IL-1RA), IL-6, IL-8 and IL-10 acted as acute phase proteins. After admission, the levels of these cytokines decreased rapidly. Single nucleotide polymorphisms did not influence cytokine production and were not associated with clinical outcome. Cytokine serum levels were significantly higher in patients with pneumococcal pneumonia. The decrease in levels of cytokines was independently influenced by the start of corticosteroid therapy.IL-1RA, IL-6, IL-8 and IL-10 are acute phase proteins, independent of genotype. Their levels are influenced by the nature of the causative microorganism and the start of corticosteroids therapy.

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Section: Community-acquired Pneumonia H Endeman Et Alsupporting

confidence: 92%

“…In sepsis, systemic cytokine levels are associated with the severity of disease [13,14]. In bacterial pneumonia the cytokine response is mostly confined to the affected lung [15][16][17][18], but systemic levels of cytokines are also raised [15-17, 19, 20].…”

mentioning

confidence: 99%

Systemic cytokine response in patients with community-acquired pneumonia

Endeman¹,

Meijvis²,

Rijkers³

et al. 2010

European Respiratory Journal

105

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show abstract

“…Since inflammatory cytokines are thought to be good markers of the severity of bacterial infections (8,20,30), we measured the levels of IL-1␤, IL-6, and TNF-␣ in the blood and liver tissues of the mice after the induction of gut-derived sepsis. Samples from each group of mice (n ϭ 9) were collected 2 days after the second administration of cyclophosphamide.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Bacteriophage Therapy against Gut-Derived Sepsis Caused by Pseudomonas aeruginosa in Mice

Watanabe

Matsumoto

Sano

et al. 2007

Antimicrob Agents Chemother

188

130

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We evaluated the efficacy of bacteriophage (phage) therapy by using a murine model of gut-derived sepsis caused by Pseudomonas aeruginosa that closely resembles the clinical pathophysiology of septicemia in humans. Oral administration of a newly isolated lytic phage strain (KPP10) significantly protected mice against mortality (survival rates, 66.7% for the phage-treated group versus 0% for the saline-treated control group; P < 0.01). Mice treated with phage also had lower numbers of viable P. aeruginosa cells in their blood, liver, and spleen. The levels of inflammatory cytokines (tumor necrosis factor alpha TNF-␣, interleukin-1␤ [IL-1␤], and IL-6) in blood and liver were significantly lower in phage-treated mice than in phage-untreated mice. The number of viable P. aeruginosa cells in fecal matter in the gastrointestinal tract was significantly lower in phage-treated mice than in the saline-treated control mice. We also studied the efficacy of phage treatment for intraperitoneal infection caused by P. aeruginosa and found that phage treatment significantly improved the survival of mice, but only under limited experimental conditions. In conclusion, our findings suggest that oral administration of phage may be effective against gut-derived sepsis caused by P. aeruginosa.

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“…Studies concerning severe pneumonia have shown that, despite the inflammatory response initially being compartmentalised [9], an increase in inflammatory cytokine levels in serum is also detected and related to poor prognosis [10][11][12][13].…”

Section: Inflammatory Response Associated With Pneumoniamentioning

confidence: 99%

Corticosteroids in severe pneumonia

Sibila¹,

Agustı́²,

Torres³

2008

European Respiratory Journal

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The mortality rate in severe community-or hospital-acquired pneumonia is very high, ranging 20-50%. Despite advances in antimicrobial therapy and supportive measures, this rate has not changed in recent years, suggesting that other factors are also responsible for the poor outcome. An abnormal increase in the local and systemic inflammatory response is associated with poor outcome, and this occurs despite adequate antibiotic therapy.There is evidence that acute administration of corticosteroids decreases the inflammatory response and might decrease mortality in severe pneumonia. This has been shown in one small randomised controlled study, terminated prematurely due to 0% mortality in the intervention arm. In addition, an experimental study showed that glucocorticosteroids decrease lung inflammatory response and lung bacterial burden, confirming the results obtained through in vitro investigations.Although these results are promising and suggest a novel role of glucocorticosteroids in pneumonia, the inherent risks and potential side-effects of these drugs require further controlled clinical trials in order to better define the target population before their general use in clinical practice. Specifically, dosage, period of administration, titration, tapering and side-effects are some of the key questions that need to be investigated.

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Patterns of Cytokine Expression in Community-Acquired Pneumonia

Cited by 137 publications

References 29 publications

Systemic cytokine response in patients with community-acquired pneumonia

Systemic cytokine response in patients with community-acquired pneumonia

Efficacy of Bacteriophage Therapy against Gut-Derived Sepsis Caused by Pseudomonas aeruginosa in Mice

Corticosteroids in severe pneumonia

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