Pro-inflammatory cytokine ratios determine the clinical course of febrile neutropenia in children receiving chemotherapy

Abstract

Background: Febrile neutropenia is a common and serious complication during treatment of childhood cancer. Empirical broad-spectrum antibiotics are usually administered until neutrophil cell count recovery. It was the aim of this study to investigate cytokine profiles as potential biomarkers using in-vitro sepsis models to differentiate between distinct clinical courses of febrile neutropenia (FN). Methods: We conducted an observational study in FN episodes of pediatric oncology patients. Courses of neutropenia were defined as severe in case of proven blood stream infection or clinical evidence of complicated infection. We collected blood samples at various time points from the onset of FN and stimulated ex vivo with lipopolysaccharide (LPS) and Staphylococcus epidermidis (SE) for 24 h. Twenty-seven cytokine levels were measured in the whole blood culture supernatants by a multiplex immunoassay system. Results: Forty-seven FN episodes from 33 children were investigated. IL-8, IL-1β, and MCP-1 expression increased significantly over time. IL-8, MIP-1α, MIP-1β, MCP-1, and TNF-α showed significantly lower concentration in patients with a clinically severe course of the FN. Conclusions: Distinct patterns of cytokine profiles seem to be able to determine infectious FN and to predict the severity of its clinical course. If these data can be verified in a multi-centre setting, this may finally lead to an individualized treatment strategy facilitating antibiotic stewardship in these patients.

Effects of Cerebrospinal Fluid Drainage on Pro-Inflammatory and Anti-Inflammatory Cytokines Expression in the Subventricular Zone of Kaolin-Induced Hydrocephalic Rats

“…In other diseases, the ratio between pro-and anti-inflammatory cytokines is estimated to be more significant than the absolute value of individual cytokines. 13,[23][24][25][26] In the hydrocephalus group on days 7, 14, and 21, our study revealed a significant imbalance in the IL-1β/IL-10 ratio, favoring the pro-inflammatory cytokine. In the hydrocephalus groups, the ratios of IL-6/IL-10 and TNF-α/IL-10 also shifted in favor of a pro-inflammatory status.…”