Cytokine profile of bronchoalveolar secretion in prolonged course of community acquired pneumonia

Abstract

Despite existing studies on pathogenetic role of cytokine (CK) system in lung damage in pneumonia, there are still controversial issues of cytokine-mediated processes that lead to the prolongation of the inflammatory process in lung tissue in this pathology. The article presents the study of the cytokine profile of bronchoalveolar secretion (BAS) in the prolonged course of community-acquired pneumonia (CAP). To achieve the purpose of the research, in patients with prolonged CAP on the first and last 1-2 days of hospital stay the concentration of pro-inflammatory (IL-1β, IL-2, TNFα, IL-6, IL-8) and anti-inflammatory CK (IL-4 and IL-10) in BAS was determined. When studying the cytokine profile of BAS in the acute period of CAP, it was found that patients with a prolonged course of the disease subsequently had an increase in the concentration of pro-inflammatory CK (IL-1β, IL-6, IL-8, TNF-α and IL -2), reduction of anti-inflammatory (IL-4, IL-10) and more significant disproportion of the ratio of their opposition pools (IL-1β/IL-10 and TNF-α/IL-10) in BAS. In the conditions of the generally accepted therapy in patients with prolonged and not prolonged CAP course, various rate of improvement of indicators of CK in BAS is defined. In patients with prolonged CAP, the rate of progress of pro-inflammatory and anti-inflammatory CK was slower. At the time of discharge from the hospital, most patients had an imbalance of pro-inflammatory and anti-inflammatory CK with a predominance of pro-inflammatory activity in the bronchoalveolar space.