Role of pro- and anti-inflammatory cytokines in activation of inflammation at community-acquired pneumonia of children with different level of physical development

Abstract

Background: With the aim of better predicting the course of the community-acquired uncomplicated pneumonia (CAUP) the study presents the results of research of the cytokine profile based on the obtained rates of pro- (interleukin 1-beta [IL-1β], tumor necrosis factor-alpha [TNF-α]) and anti-inflammatory (interleukin 4 [IL-4]) cytokines in blood serum as well as results of the combined bacteriological and serological research of children with different level of physical development (PD), sick on CAUP.

Methods: In order to reach the purpose of the research the work was carried out by controlled computer-generated randomization schedule in 2 stages. At the 1st stage the examination of 151 children with CAUP aged from 3 to 14 years from the onset of the disease and of 20 apparently healthy children (control group) was held. All children passed a study of sputum using staining of swabs according to Gram, culture test and determination of causative agents of pneumonia by the method of enzyme multiplied immunoassay (ELISA); in addition, the cytokine profile (IL-1β, IL-4 and TNF-α) was determined by the method of enzyme-linked immunosorbent assay. At the 2nd stage, according to the inclusion/exclusion criteria, 151 children in the dynamics of the disease were examined: on 7.2 ± 0.9 day from the onset of the disease, the cytokine profile rates were evaluated, and on 12.6 ± 0.9 day the level of IgM, IgG to atypical causative agents of pneumonia were recorded.

Results: The results obtained during the research of the indices of the pro-inflammatory (IL-1β and TNF-α) and anti-inflammatory (IL-4) cytokines in blood serum of the children with CAUP and having different level of PD can be considered as factors for individually predicting the course of the CAUP of children with different PD.

Conclusion: Data suggest that the ratio of pro- and anti-inflammatory cytokines during in­flammatory process in children with CAUP with different PD can be one of the additional, but not unique, factors for predicting the course of the dis­ease.