Cytokine concentrations in bronchoalveolar lavage fluid (BALF) from
children with severe community-acquired pneumonia (SCAP) from Shanghai
Abstract
Background: It has been well known that overreaction of host immune
systems plays a critical role in severe community-acquired pneumonia
(SCAP). However, few of previous studies focused on the association
between cytokine concentrations in bronchoalveolar lavage fluid (BALF)
and SCAP. Object: We examined cytokine concentrations in BALF from
children with SCAP and explored predictive value of cytokine
concentrations for SCAP. Method: It was a retrospective study. A total
of 100 children with SCAP who underwent parallel bronchoalveolar lavage
between July 2017 and June 2019 were enrolled. 100 patients with mild
community-acquired pneumonia (MCAP) who were admitted to the hospital
were matched based on age and sex during the same time period . Basic
clinical information were collected. Flow cytometry was used to
determine the cytokine concentrations in BALF. Receiver operating
characteristic curve was used to analyze their predictive value for
SCAP. Result: A total of 106 males and 94 females were included in this
study. The results showed that the CRP, PCT, ESR, LDH, and D-dimer were
significantly increased in the SCAP group. The SCAP patients also had
longer fever duration, hospitalization stays, and higher hospitalization
costs. The IL-5,IL-17A,IL-18,and TnF-α in BALF of SCAP group were
significantly higher than those in MCAP group. ROC curve analysis
demonstrated AUC of those cytokines were all among
0.5~0.7. Conclusion: The IL-5,IL-17A,IL-18,and TnF-α
in BALF of children with SCAP group were highe. However, the efficacy of
those cytokines in the clinical diagnosis of SCAP is not excellent to be
used as a predictor.