Cargando…

Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia

BACKGROUND: The inflammatory response to community‐acquired pneumonia (CAP) is orchestrated through activation of cytokine networks and the complement system. We examined the association of multiple cytokines and the terminal complement complex (TCC) with microbial aetiology, disease severity and sh...

Descripción completa

Detalles Bibliográficos
Autores principales: Siljan, William W., Holter, Jan C., Nymo, Ståle H., Husebye, Einar, Ueland, Thor, Aukrust, Pål, Mollnes, Tom E., Heggelund, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767742/
https://www.ncbi.nlm.nih.gov/pubmed/29171871
http://dx.doi.org/10.1111/eci.12865
_version_ 1783292582621609984
author Siljan, William W.
Holter, Jan C.
Nymo, Ståle H.
Husebye, Einar
Ueland, Thor
Aukrust, Pål
Mollnes, Tom E.
Heggelund, Lars
author_facet Siljan, William W.
Holter, Jan C.
Nymo, Ståle H.
Husebye, Einar
Ueland, Thor
Aukrust, Pål
Mollnes, Tom E.
Heggelund, Lars
author_sort Siljan, William W.
collection PubMed
description BACKGROUND: The inflammatory response to community‐acquired pneumonia (CAP) is orchestrated through activation of cytokine networks and the complement system. We examined the association of multiple cytokines and the terminal complement complex (TCC) with microbial aetiology, disease severity and short‐term outcome. MATERIALS AND METHODS: Plasma levels of 27 cytokines and TCC were analysed in blood samples obtained at hospital admission, clinical stabilization and 6‐week follow‐up from 247 hospitalized adults with CAP. Fourteen mediators were included in final analyses. Adverse short‐term outcome was defined as intensive care unit (ICU) admission and 30‐day mortality. RESULTS: Cytokine and TCC levels were dynamic in the clinical course of CAP, with highest levels seen at admission for most mediators. Admission levels of cytokines and TCC did not differ between groups of microbial aetiology. High admission levels of IL‐6 (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.18‐1.84, P = .001), IL‐8 (OR 1.79, 95% CI 1.26‐2.55, P = .001) and MIP‐1β (OR 2.28, 95% CI 1.36‐3.81, P = .002) were associated with a CURB‐65 severity score of ≥3, while IL‐6 (OR 1.37, 95% CI 1.07‐1.74, P = .011) and MIP‐1β (OR 1.86, 95% CI 1.03‐3.36, P = .040) were associated with a high risk of an adverse short‐term outcome. CONCLUSIONS: In this CAP cohort, admission levels of IL‐6, IL‐8 and MIP‐1β were associated with disease severity and/or adverse short‐term outcome. Still, for most mediators, only nonsignificant variations in inflammatory responses were observed for groups of microbial aetiology, disease severity and short‐term outcome.
format Online
Article
Text
id pubmed-5767742
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-57677422018-02-01 Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia Siljan, William W. Holter, Jan C. Nymo, Ståle H. Husebye, Einar Ueland, Thor Aukrust, Pål Mollnes, Tom E. Heggelund, Lars Eur J Clin Invest Original Articles BACKGROUND: The inflammatory response to community‐acquired pneumonia (CAP) is orchestrated through activation of cytokine networks and the complement system. We examined the association of multiple cytokines and the terminal complement complex (TCC) with microbial aetiology, disease severity and short‐term outcome. MATERIALS AND METHODS: Plasma levels of 27 cytokines and TCC were analysed in blood samples obtained at hospital admission, clinical stabilization and 6‐week follow‐up from 247 hospitalized adults with CAP. Fourteen mediators were included in final analyses. Adverse short‐term outcome was defined as intensive care unit (ICU) admission and 30‐day mortality. RESULTS: Cytokine and TCC levels were dynamic in the clinical course of CAP, with highest levels seen at admission for most mediators. Admission levels of cytokines and TCC did not differ between groups of microbial aetiology. High admission levels of IL‐6 (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.18‐1.84, P = .001), IL‐8 (OR 1.79, 95% CI 1.26‐2.55, P = .001) and MIP‐1β (OR 2.28, 95% CI 1.36‐3.81, P = .002) were associated with a CURB‐65 severity score of ≥3, while IL‐6 (OR 1.37, 95% CI 1.07‐1.74, P = .011) and MIP‐1β (OR 1.86, 95% CI 1.03‐3.36, P = .040) were associated with a high risk of an adverse short‐term outcome. CONCLUSIONS: In this CAP cohort, admission levels of IL‐6, IL‐8 and MIP‐1β were associated with disease severity and/or adverse short‐term outcome. Still, for most mediators, only nonsignificant variations in inflammatory responses were observed for groups of microbial aetiology, disease severity and short‐term outcome. John Wiley and Sons Inc. 2017-12-07 2018-01 /pmc/articles/PMC5767742/ /pubmed/29171871 http://dx.doi.org/10.1111/eci.12865 Text en © 2017 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Siljan, William W.
Holter, Jan C.
Nymo, Ståle H.
Husebye, Einar
Ueland, Thor
Aukrust, Pål
Mollnes, Tom E.
Heggelund, Lars
Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
title Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
title_full Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
title_fullStr Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
title_full_unstemmed Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
title_short Cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
title_sort cytokine responses, microbial aetiology and short‐term outcome in community‐acquired pneumonia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767742/
https://www.ncbi.nlm.nih.gov/pubmed/29171871
http://dx.doi.org/10.1111/eci.12865
work_keys_str_mv AT siljanwilliamw cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT holterjanc cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT nymostaleh cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT husebyeeinar cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT uelandthor cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT aukrustpal cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT mollnestome cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia
AT heggelundlars cytokineresponsesmicrobialaetiologyandshorttermoutcomeincommunityacquiredpneumonia