Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Iran J Immunol. 2020 Sep;17(3):185-203. doi: 10.22034/iji.2020.87266.1793.
Given the high mortality of bacterial bloodstream infections (BSI), blood culture results do not meet clinical needs timely due to being time-consuming and having low positive rate. Whether we can identify the severity and type of bacterial infections by cytokines is a controversial issue.
To investigate the dynamic change of cytokines in BSI.
55 patients with Gram-positive (GP) BSI, 64 patients with Gram-negative (GN) BSI and 52 healthy controls were enrolled. We quantitatively detected the cytokines interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ) by flow cytometry in the sera. The levels of procalcitonin, C-reactive protein, leukocytes and neutrophils were also detected simultaneously.
There were significantly up-regulated IL-6 and IL-10 expression in BSI patients, particularly in the GN-BSI, for instance Escherichia coli and Klebsiella pneumoniae infections; following the treatment, IL-6 and IL-10 decreased by 10-23 and 4-27 times, respectively. Additionally, IL-2, TNF-α and IFN-γ expression increased slightly in BSI patients and IFN-γ expression declined as GN-BSI progressed.
IL-6 and IL-10 are closely associated with the severity and treatment efficacy of BSI, and can help to distinguish between GP-BSI and GN-BSI at an early stage.
由于血液培养结果耗时且阳性率低，导致细菌性血流感染（BSI）的死亡率很高，无法及时满足临床需求。我们能否通过细胞因子来识别细菌感染的严重程度和类型是一个有争议的问题。
探讨 BSI 中细胞因子的动态变化。
纳入 55 例革兰阳性（GP）BSI 患者、64 例革兰阴性（GN）BSI 患者和 52 例健康对照者。通过流式细胞术定量检测血清中白细胞介素（IL）-2、IL-4、IL-6、IL-10、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）。同时检测降钙素原、C 反应蛋白、白细胞和中性粒细胞的水平。
BSI 患者的 IL-6 和 IL-10 表达明显上调，尤其是在 GN-BSI 患者中，例如大肠埃希菌和肺炎克雷伯菌感染；经过治疗，IL-6 和 IL-10 分别降低了 10-23 和 4-27 倍。此外，BSI 患者的 IL-2、TNF-α和 IFN-γ表达略有增加，随着 GN-BSI 的进展，IFN-γ表达下降。
IL-6 和 IL-10 与 BSI 的严重程度和治疗效果密切相关，有助于在早期区分 GP-BSI 和 GN-BSI。
