Plasma IL-6/IL-10 Ratio and IL-8, LDH, and HBDH Level Predict the Severity and the Risk of Death in AIDS Patients withPneumocystisPneumonia

Abstract

Objective. To identify blood biomarkers to predict severity and mortality in AIDS PCP patients. Methods. Biomarkers including clinical parameters and plasma inflammatory cytokines were assessed in 32 HIV-infected patients with Pneumocystis pneumonia (PCP) at time of admission. Predictive value of the biomarkers for clinical severity and in-hospital mortality was evaluated by corresponding ROC curve. Results. Levels of CRP, WBC, LDH, HBDH, and Ferritin were significantly higher in the severe and nonsurvivor AIDS PCP patients. These important biochemical indicators have inverse correlation with oxygenation index, especially levels of LDH (P = 0.008, R 2 = 0.258), HBDH (P = 0.001, R 2 = 0.335), and Ferritin (P = 0.005, R 2 = 0.237). Plasma IL-8 and IL-6 levels were significantly higher in patients with PaO2/FiO2 ≤ 200 mmHg and nonsurvivors than in those with PaO2/FiO2 > 200 mmHg and survivors. Severe and nonsurvival groups showed higher ratio of mean IL-6/IL-10 level (1.78 ± 1.56, P < 0.001; 1.11 ± 0.72, P = 0.043), larger AUC (95% CI 0.781–1.000, P < 0.001; 95% CI 0.592–0.917, P = 0.043), and more significantly inverse correlation with the oxygenation index. Conclusion. Plasma IL-8, LDH, and HBDH levels and IL-6/IL-10 ratio could be helpful for early evaluation of the severity and predicting fatal outcomes in AIDS PCP patients.

Mechanisms of Action of Vitamin D as Supplemental Therapy for Pneumocystis Pneumonia

“…IL-6 is another proinflammatory cytokine. Serum IL-6 levels were found to be higher in AIDS patients who died of PCP than in those who survived PCP (14). Non-AIDS patients with PCP also had significantly higher levels of IL-6 in their BAL fluids than non-PCP patients (15,16).…”

Treatment with 3-aminobenzamide during ex vivo lung perfusion of damaged rat lungs reduces graft injury and dysfunction after transplantation

“…This differential action of 3-AB on IL-6 and IL-10 is consistent with previous findings showing that PARP inhibitors have smaller effects on anti-inflammatory than pro-inflammatory mediators. 38 It is worth mentioning that the ratio IL-6/IL-10 represents an important indicator of the pro-to anti-inflammatory balance in the lung, with major prognostic significance in the setting of lung inflammation 12 and LTx. 13 Then, 3-AB therapy during EVLP appears to switch the immune response from a predominantly pro-inflammatory to a predominantly anti-inflammatory profile after LTx, which is in line with findings reported in unrelated pathophysiological conditions.…”

“…After centrifugation (5000 rpm, 10 minutes), the levels of lactate dehydrogenase (LDH) and the cytokines interleukin‐6 (IL‐6) and interleukin‐10 (IL‐10) were determined in the clear supernatants, using commercial enzyme‐linked immunosorbent assay (ELISA) kits (R&D Systems) as described previously . The ratio IL‐6/IL‐10 was calculated as an index of inflammatory/anti‐inflammatory balance . In the BAL from the left transplanted lung, the cell pellets were resuspended in PBS, cells were counted in a hemocytometer, cytospinned (800 rpm, 5 minutes), and stained (Diff‐Quik) to count polymorphonuclear neutrophils (PMNs) and mononuclear cells (MNs).…”

“…5,9 The ratio IL-6/IL-10 was calculated as an index of inflammatory/anti-inflammatory balance. 12,13 In the BAL from the left transplanted lung, the cell pellets were resuspended in PBS, cells were counted in a hemocytometer, cytospinned (800 rpm, 5 minutes), and stained (Diff-Quik) to count polymorphonuclear neutrophils (PMNs) and mononuclear cells (MNs). In addition, IL-6 and IL-10 were also measured in plasma samples obtained at the end of experiments.…”

Biomarkers of Infection and Inflammation

“…70 Novel biomarkers for pneumonia are continually sought with several studies investigating the potential of interleukin-6 (IL-6), a cytokine in the acute phase response that is elevated in patients with pneumonia. 67,[71][72][73] Invasive fungal infections are of worldwide importance due to an increasing immunosuppressed population and increasing numbers of transplant recipients. 74 For more than two decades research has been ongoing for two fungal biomarkers, galactomannan (GM) and 1,3-β-D-glucan (BDG).…”