Benfield T L, Vestbo J, Junge J, Nielsen T L, Jensen A B, Lundgren J D
Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark.
Am J Respir Crit Care Med. 1995 Apr;151(4):1058-62. doi: 10.1164/ajrccm/151.4.1058.
Interleukin-8 (IL-8) is a potent neutrophil chemoattractant and activator. Pneumocystis carinii pneumonia is associated with an accumulation of neutrophils in bronchoalveolar lavage (BAL) fluid. Thus, we hypothesized that IL-8 is involved in the pathogenesis of P. carinii pneumonia. BAL fluid and serum were prospectively collected in 76 consecutive HIV-infected patients with a primary episode of P. carinii pneumonia, as well as in 10 healthy control subjects. Patients were found to have elevated levels of IL-8 in BAL fluid compared with control subjects (p < 0.01). Nine patients died during the course of P. carinii pneumonia. Comparing survivors with nonsurvivors, the median IL-8 level in BAL fluid was 127 (0 to 3,900) versus 584 (127 to 6,100) pg/ml (p < 0.05). Furthermore, patients with levels of IL-8 in BAL fluid greater than 90 pg/ml (i.e., greater than control subjects) had significantly worse vital prognosis (log rank test, p < 0.05). Thirteen percent required mechanical ventilation (MV). Patients requiring MV had a median IL-8 level of 396 (25 to 6,100) versus 129 (0 to 3,900) pg/ml for patients not requiring MV (p < 0.05).
i) IL-8 in BAL fluid correlates to the clinical severity of the pneumonia, and ii) is a predictor of mortality and severe respiratory compromise.
白细胞介素-8（IL-8）是一种有效的中性粒细胞趋化因子和激活剂。卡氏肺孢子虫肺炎与支气管肺泡灌洗（BAL）液中中性粒细胞的积聚有关。因此，我们推测IL-8参与了卡氏肺孢子虫肺炎的发病机制。前瞻性收集了76例连续的原发性卡氏肺孢子虫肺炎HIV感染患者以及10名健康对照者的BAL液和血清。发现患者BAL液中IL-8水平高于对照者（p<0.01）。9例患者在卡氏肺孢子虫肺炎病程中死亡。比较存活者与非存活者，BAL液中IL-8水平的中位数分别为127（0至3900）与584（127至6100）pg/ml（p<0.05）。此外，BAL液中IL-8水平高于90 pg/ml（即高于对照者）的患者的重要预后明显更差（对数秩检验，p<0.05）。13%的患者需要机械通气（MV）。需要MV的患者IL-8水平中位数为396（25至6100）pg/ml，而不需要MV的患者为129（0至3900）pg/ml（p<0.05）。
i）BAL液中的IL-8与肺炎的临床严重程度相关，ii）是死亡率和严重呼吸功能不全的预测指标。
