Factors associated with inflammatory cytokine patterns in community-acquired pneumonia

Eur Respir J. 2011 Feb;37(2):393-9. doi: 10.1183/09031936.00040710. Epub 2010 Jul 1.

Abstract

Raised systemic levels of interleukin (IL)-6 and IL-10 cytokines have been associated with poorer outcome in community-acquired pneumonia. The aim of our study was to identify potential associated factors with increased levels of IL-6, IL-10, or both cytokines. We performed a prospective study of 685 patients admitted to hospital with community-acquired pneumonia. IL-6 and IL-10 were measured in blood in the first 24 h. 30-day mortality increased from 4.8% to 11.4% (p = 0.003) when both cytokines were higher than the median. Independent associated factors with an excess of IL-6 were neurologic disease, confusion, serum sodium < 130 mEq·L⁻¹, pleural effusion, and bacteraemia. The associated factors for an excess of IL-10 were respiratory rate ≥ 30 breaths·min⁻¹, systolic blood pressure < 90 mmHg and glycaemia ≥ 250 mg·dL⁻¹. The independent associated factors for an excess of both cytokines were confusion, systolic blood pressure < 90 mmHg, pleural effusion and bacteraemia. Protective factors were prior antibiotic treatment and pneumococcal vaccination. Different independent factors are related to an excess of IL-6 and IL-10. Confusion, hypotension, pleural effusion and bacteraemia were associated with the inflammatory profile with the highest mortality rate, whereas anti-pneumococcal vaccination and previous antibiotic treatment appeared to be protective factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / mortality
  • Blood Pressure / drug effects
  • Community-Acquired Infections / blood*
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / mortality*
  • Comorbidity
  • Confusion / blood
  • Female
  • Humans
  • Interleukin-10 / blood*
  • Interleukin-6 / blood*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Nervous System Diseases / blood
  • Nervous System Diseases / drug therapy
  • Nervous System Diseases / mortality
  • Pleural Effusion / drug therapy
  • Pleural Effusion / mortality
  • Pneumococcal Vaccines / therapeutic use
  • Pneumonia, Bacterial / blood*
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / mortality*
  • Prospective Studies
  • Respiration / drug effects
  • Severity of Illness Index
  • Sodium / blood

Substances

  • Anti-Bacterial Agents
  • Interleukin-6
  • Pneumococcal Vaccines
  • Interleukin-10
  • Sodium