Abstract
Poor prognosis in CAP patients could be associated with an unbalanced inflammatory response in terms of pro- and anti-inflammatory cytokines relationship. The aim of our study was to evaluate the impact of the inflammatory response on admission and time to reach clinical stability (TCS) in hospitalized patients with CAP. An observational, prospective study was performed on consecutive patients hospitalised for CAP from April to December 2010 at the Respiratory Dpt., Policlinico Hospital, Milan, Italy. Cytokines were detected on blood samples collected within 24 hours from the admission with a high sensitivity immunoassay, and were classified as pro-inflammatory (IL6) and anti-inflammatory (IL4 and IL10). Gradients between the latter and the former were also calculated. Two groups of patients were identified: those who reached CS within 3 days from the admission (Group A) and the rest of population (Group B).
A total of 43 subjects were prospectively enrolled (26 males; mean±SD age: 71±18 yrs). Cytokine values are shown in Table according to the two study groups.
Negative correlations were found between IL10/IL6 ratio and TCS (r: -0.372, p=0.014), as well as IL4/IL6 ratio and TCS (r: -0.312, p=0.042).
An effective anti-inflammatory response seems to be a protective factor, whilst individuals showing unbalanced pro-inflammatory patterns take a longer time to recover. Further research is needed to assess the potential application of specific therapeutic agents in order to attenuate inflammatory damage.
- © 2011 ERS