Clinical Investigations

Acute Phase Reactants and Cytokine Levels in Unilateral Community-Acquired Pneumonia
Mustafa Kolsuz^a, Sinan Erginel^b, Ozkan Alata^c, Füsun Alata^b, Muzaffer Metinta^b, Irfan Uçgun^b, Emel Harmanci^b, Omer Çolak<sup>c

a</sup>Tuberculosis Control Dispensary, and Departments of
^bChest Disease and
^cBiochemistry, Osmangazi University Medical Faculty, Eskisehir, Turkey

Address of Corresponding Author

Respiration 2003;70:615-622 (DOI: 10.1159/000075208)

  Key Words

• Bronchoalveolar lavage fluid
• C-reactive protein
• Pneumonia
• Cytokine levels, serum

  Abstract

Background: Bacterial infection of the lower respiratory tract initiates an acute inflammatory response. Regulation of the inflammatory response in bacterial pneumonia depends on a complex interaction between immune cells and inflammatory cytokines. Objectives: We investigated the initial levels of proinflammatory cytokines and acute phase reactants (APR), e.g. C-reactive protein (CRP), upon presentation of community-acquired pneumonia (CAP) in relation to clinical and laboratory indices of infection. Methods: We prospectively studied 28 consecutive patients with unilateral CAP. Tumor necrosis factor- (TNF-), interleukin (IL)-1, IL-6 and IL-8 concentrations were measured by ELISA in both bronchoalveolar lavage (BAL) fluid and serum. Results: The concentrations of IL1- and IL-6 in BAL fluid were found to be significantly higher in the involved lung than those in either the noninvolved lung (p = 0.008 and p = 0.012, respectively) or serum (p = 0.002 and p = 0.025, respectively). Serum CRP concentrations were increased compared to those in the involved and noninvolved lung in BAL fluid (p = 0.000 and p = 0.000, respectively). In serum and BAL from involved lung, IL-6 concentrations were higher in the systemic inflammatory response syndrome (SIRS) group than in the non-SIRS group (p < 0.05), whereas CRP, TNF- , IL-1 and IL-8 concentrations showed no difference between SIRS and non-SIRS. There was no significant correlation between the acute physiology and chronic health evaluation II score and the cytokines. Conclusions: Our results indicate that the CRP level is higher in the serum than in the BAL fluid in the lung, and that IL-6 is the most important cytokine for the determination of the severity of the disease.

Copyright © 2003 S. Karger AG, Basel

  Author Contacts

Dr. Mustafa Kolsuz
Kirmizitoprak Mahallesi, Tandogan Sokak
Soy-Gür Apt. A Blok No:40/1
TR-Eskisehir (Turkey)
Tel. +90 222 2267412, Fax +90 222 2394714, E-Mail mustafakolsuz@hotmail.com

  Article Information

Received: March 22, 2002
Accepted after revision: June 3, 2003
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 4, Number of References : 32