Abstract
Understanding inflammatory response is a crucial issue in the management of CAP. The aim of our study was to evaluate both local (lung) and systemic (serum) inflammation on admission 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. Within 24 hours after admission, specimens of blood and exhaled breath condensate (EBC) were collected. The following cytokines were detected on both samples with a high sensitivity immunoassay: pro-inflammatory (IL1α, IL1β, IL2, IL6, IL8, TNFα and IFNγ) and anti-inflammatory (IL4 and IL10).
A total of 43 subjects were prospectively enrolled (26 males; mean±SD age: 71±18 yrs). Local and systemic inflammatory patterns on admission are shown in Table (Mean ± SD).
Pro-inflammatory interleukins were increased in patients undergoing mechanical ventilation on admission in comparison to the rest of the population in both serum (IL1α 0.57±1.02 vs. 0.11±0.12, respectively, p= 0.007) and EBC (IL1α 0.31±0.28 vs. 0.08±0.06, respectively, p=0.001).
These findings may help to understand the decompartmentalization of the inflammatory response, which takes place since the very early stages of the infection in hospitalized patients with CAP.
- © 2011 ERS