PT  - JOURNAL ARTICLE
AU  - P Glynn
AU  - R Coakley
AU  - I Kilgallen
AU  - N Murphy
AU  - S O’Neill
TI  - Circulating interleukin 6 and interleukin 10 in community acquired pneumonia
AID  - 10.1136/thx.54.1.51
DP  - 1999 Jan 01
TA  - Thorax
PG  - 51--55
VI  - 54
IP  - 1
4099  - http://thorax.bmj.com/content/54/1/51.short
4100  - http://thorax.bmj.com/content/54/1/51.full
SO  - Thorax1999 Jan 01; 54
AB  - BACKGROUND Inflammatory 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.METHODS Circulating 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.RESULTS 80% 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.CONCLUSIONS This 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.