儿童患者实验室确诊的细菌性脑膜炎的血清细胞因子谱。

Serum cytokine profile of pediatric patients with laboratory confirmed pneumococcal meningitis.

机构信息

Department of Medical Microbiology, Capital Medical University, Beijing, China.

Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

出版信息

J Infect Public Health. 2021 Apr;14(4):514-520. doi: 10.1016/j.jiph.2021.01.010. Epub 2021 Jan 19.

DOI:10.1016/j.jiph.2021.01.010

PMID:33743374

Abstract

BACKGROUND

Streptococcus pneumoniae infection is a leading cause of bacterial meningitis in children with severe sequelae. Cytokines are important molecules in regulating of host inflammatory and anti-inflammatory responses. So far, the cytokine profile of bacterial meningitis caused by single pathogen has been rarely reported. The aim of this study was to explore serum cytokine profile in pediatric patients with pneumococcal meningitis (PM) and its clinical relevance which could be considered as a valuable tool for differential diagnosis of PM.

METHODS

During 2015-2018, 95 children with laboratory-confirmed PM were included. Of them, 63 had serum samples at admission. Ten cytokines including TNF-α, IL-12p40, IL-17A, IL-1β, IFN-γ, GM-CSF, IL-10, CXCL-1, IL-8 and IL-13 were measured by multiplex immunoassay in sera of 63 PM patients and 55 age-matched healthy controls (HCs). Level of serum cytokines was compared with different clinical features of patients.

RESULTS

Significantly higher level of IL-10 was observed in patients than HCs (median, 2.19 vs. 1.92 pg/mL, p = 0.017). Significantly lower levels of serum IL-12p40, IL-17A and IL-1β were observed in patients than HCs (median, 0.68 vs. 10.12 pg/mL, p < 0.0001; 1.14 vs. 1.14 pg/mL, p = 0.004; 1.00 vs. 5.09 pg/mL, p < 0.0001, respectively). No difference was found in levels of other cytokines between patients and controls. A negative correlation was noticed between percentages of blood neutrophils and concentrations of IL-10 (p = 0.048, r = -0.25). Significantly lower levels of IL-12p40 and CXCL-1 were observed in PM patients with sepsis than those without (median 0.68 vs. 1.64 pg/mL, p = 0.026; 7.25 vs. 12.84 pg/mL, p = 0.043, respectively).

CONCLUSIONS

Our results suggested that there might be significant changes in serum pro-inflammatory and anti-inflammatory cytokines in PM children and that the determination of these cytokines may have limited value for evaluation of clinical outcome of pediatric PM.

摘要

背景

肺炎链球菌感染是儿童细菌性脑膜炎的主要病因，可导致严重后遗症。细胞因子是调节宿主炎症和抗炎反应的重要分子。目前，单一病原体引起的细菌性脑膜炎的细胞因子谱鲜有报道。本研究旨在探讨儿童肺炎链球菌性脑膜炎（PM）患者血清细胞因子谱及其临床相关性，以期为 PM 的鉴别诊断提供有价值的工具。

方法

本研究纳入了 2015 年至 2018 年期间 95 例经实验室确诊的 PM 患儿，其中 63 例患儿入院时采集了血清样本。采用多指标免疫分析法检测 63 例 PM 患儿和 55 例年龄匹配的健康对照者（HCs）血清中 TNF-α、IL-12p40、IL-17A、IL-1β、IFN-γ、GM-CSF、IL-10、CXCL-1、IL-8 和 IL-13 共 10 种细胞因子的水平。比较了不同临床特征患儿血清细胞因子水平的差异。

结果

与 HCs 相比，PM 患儿血清中 IL-10 水平明显升高（中位数，2.19 vs. 1.92 pg/mL，p = 0.017）。与 HCs 相比，PM 患儿血清中 IL-12p40、IL-17A 和 IL-1β 水平明显降低（中位数，0.68 vs. 10.12 pg/mL，p < 0.0001；1.14 vs. 1.14 pg/mL，p = 0.004；1.00 vs. 5.09 pg/mL，p < 0.0001，分别）。患儿和对照组之间其他细胞因子水平无差异。血中性粒细胞百分比与 IL-10 浓度呈负相关（p = 0.048，r = -0.25）。败血症患儿血清中 IL-12p40 和 CXCL-1 水平明显低于非败血症患儿（中位数 0.68 vs. 1.64 pg/mL，p = 0.026；7.25 vs. 12.84 pg/mL，p = 0.043，分别）。