Thorax 1999;54:51-55 ( January )

Circulating interleukin 6 and interleukin 10 in community acquired pneumonia

P Glynn, R Coakley, I Kilgallen, N Murphy, S O'Neill

Beaumont Hospital, Beaumont Road, Dublin 9, Ireland

Correspondence to: Dr S O'Neill.

Received 5 March 1998; Returned to authors 29 June 1998; Revised version received 17 August 1998; Accepted for publication 26 August 1998

BACKGROUNDInflammatory cytokine concentrations correlate with severity of sepsis. We hypothesised that patients with community acquired pneumonia (CAP) associated with systemic inflammatory response syndrome (SIRS) would have greater interleukin 6 (IL-6) production due to activation of the inflammatory cytokine cascade, matched by a significant anti-inflammatory cytokine response. Interleukin 10 (IL-10) was evaluated as a potential surrogate marker of severity of sepsis in CAP and age related impairment of the cytokine response was studied in elderly patients with CAP.
METHODSCirculating immunoreactive IL-6 and IL-10 levels were measured in 38 patients with CAP subdivided into a group fulfilling the criteria for SIRS (n = 28) and a non-SIRS group (n = 10) in a variety of age groups and correlated with APACHE II scores.
RESULTS80% had circulating IL-6 levels (median 46.7 pg/ml, range 4.6-27 000) and 60% had circulating IL-10 levels (median 15.5 pg/ml, range 2.5-765). Concentrations of both were significantly increased in patients with SIRS compared with non-SIRS patients. Those with activation of the inflammatory cytokine cascade (IL-6 positive) produced more IL-10 than IL-6 negative patients. Older patients had a similar cytokine response. Both cytokines correlated positively with APACHE II scores.
CONCLUSIONSThis is the first demonstration of circulating IL-10 in CAP. A greater counter-inflammatory response in patients with SIRS and in IL-6 positive patients suggests a potential immunomodulatory role for IL-10 in controlling the inflammatory cytokine response in CAP. IL-10 concentrations correlate with severity of illness in CAP and may be of prognostic importance. There is no age related impairment in the cytokine response.

Keywords: interleukin 6; interleukin 10; community acquired pneumonia

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© 1999 by Thorax
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