Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan.
Microbiol Immunol. 2012 Sep;56(9):651-5. doi: 10.1111/j.1348-0421.2012.00489.x.
Severe pneumonia and leukocytosis are characteristic, frequently observed, clinical findings in pediatric patients with pandemic A/H1N1/2009 influenza virus infection. The aim of this study was to elucidate the role of cytokines and chemokines in complicating pneumonia and leukocytosis in patients with pandemic A/H1N1/2009 influenza virus infection. Forty-seven patients with pandemic A/H1N1/2009 influenza virus infection were enrolled in this study. Expression of interleukin (IL)-10 (P = 0.027) and IL-5 (P = 0.014) was significantly greater in patients with pneumonia than in those without pneumonia. Additionally, serum concentrations of interferon-γ (P = 0.009), tumor necrosis factor-α (P = 0.01), IL-4 (P = 0.024), and IL-2 (P = 0.012) were significantly lower in pneumonia patients with neutrophilic leukocytosis than in those without neutrophilic leukocytosis. Of the five serum chemokine concentrations assessed, only IL-8 was significantly lower in pneumonia patients with neutrophilic leukocytosis than in those without leukocytosis (P = 0.001). These cytokines and chemokines may play important roles in the pathogenesis of childhood pneumonia associated with A/H1N1/2009 influenza virus infection.
严重肺炎和白细胞增多是儿科患者感染大流行性 A/H1N1/2009 流感病毒后常见的特征性临床发现。本研究旨在阐明细胞因子和趋化因子在大流行性 A/H1N1/2009 流感病毒感染患者并发肺炎和白细胞增多中的作用。本研究共纳入 47 例大流行性 A/H1N1/2009 流感病毒感染患者。与无肺炎患者相比，肺炎患者的白细胞介素（IL）-10（P = 0.027）和 IL-5（P = 0.014）的表达明显更高。此外，中性粒细胞性白细胞增多性肺炎患者血清干扰素-γ（P = 0.009）、肿瘤坏死因子-α（P = 0.01）、IL-4（P = 0.024）和 IL-2（P = 0.012）的浓度明显低于无中性粒细胞性白细胞增多性肺炎患者。在评估的五种血清趋化因子浓度中，只有中性粒细胞性白细胞增多性肺炎患者的白细胞介素-8（P = 0.001）明显低于无白细胞增多性肺炎患者。这些细胞因子和趋化因子可能在与 A/H1N1/2009 流感病毒感染相关的儿童肺炎发病机制中发挥重要作用。
