Antunes G, Evans S A, Lordan J L, Frew A J
Dept of University Medicine, Southampton General Hospital, UK.
Eur Respir J. 2002 Oct;20(4):990-5. doi: 10.1183/09031936.02.00295102.
Pro-inflammatory and anti-inflammatory cytokines are important mediators in the host response to infection. In contrast to the pro-inflammatory cytokines little is known about anti-inflammatory cytokines in community-acquired pneumonia (CAP) and their relation to disease severity. Circulating levels of three pro-inflammatory cytokines (interleukin (IL)-1beta, IL-6 and tumour necrosis factor (TNF)-alpha) and two anti-inflammatory cytokines (IL-10, IL-1 receptor antagonist (IL-1ra)) were measured using an enzyme immunoassay on admission, day 3 and day 5 in 24 patients with CAP. The modified British Thoracic Society (BTS) prognostic rule and Acute Physiology and Chronic Health Evaluation (APACHE) II score were used to assess disease severity. IL-6, TNF-alpha, IL-10 and IL-1ra concentrations were detected in most patients on admission and decreased significantly on day 3 and day 5 in all survivors. A significant difference between the BTS high-risk and low-risk groups was only found for IL-6 (median (range) 477 pg x mL(-1) (7.6-1402 pg x mL(-1)) versus 81.6 pg x mL(-1) (0-943 pg x mL(-1)); p<0.05). IL-6 also correlated with the APACHE II scores on admission. Concentrations of anti-inflammatory cytokines were elevated on admission in community-acquired pneumonia but they did not correlate with disease severity scores.
促炎细胞因子和抗炎细胞因子是宿主对感染反应中的重要介质。与促炎细胞因子相比，人们对社区获得性肺炎（CAP）中的抗炎细胞因子及其与疾病严重程度的关系知之甚少。采用酶免疫分析法对24例CAP患者入院时、第3天和第5天的三种促炎细胞因子（白细胞介素（IL）-1β、IL-6和肿瘤坏死因子（TNF）-α）和两种抗炎细胞因子（IL-10、IL-1受体拮抗剂（IL-1ra））的循环水平进行了检测。采用改良的英国胸科学会（BTS）预后规则和急性生理与慢性健康状况评估（APACHE）II评分来评估疾病严重程度。大多数患者入院时检测到IL-6、TNF-α、IL-10和IL-1ra浓度，所有存活患者在第3天和第5天显著下降。仅在IL-6方面发现BTS高危组和低危组之间存在显著差异（中位数（范围）477 pg·mL-1（7.6-1402 pg·mL-1）对81.6 pg·mL-1（0-943 pg·mL-1）；p<0.05）。IL-6也与入院时的APACHE II评分相关。社区获得性肺炎患者入院时抗炎细胞因子浓度升高，但它们与疾病严重程度评分无关。
