Cytokine kinetic profiles in children with acute lower respiratory tract infection: a post hoc descriptive analysis from a randomized control trial
Standard inflammatory markers and chest radiography lack the ability to discriminate bacterial from non-bacterial lower respiratory tract infection (LRTI). Cytokine profiles may serve as biomarkers for LRTI, but their applicability to identify aetiology, severity of disease and need for antibiotic p...
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| Veröffentlicht in: | Clinical microbiology and infection 2018-12, Vol.24 (12), p.1341.e1-1341.e7 |
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| creator | Fuchs, A. Gotta, V. Decker, M.-L. Szinnai, G. Baumann, P. Bonhoeffer, J. Ritz, N. Baer, G. Berthet, G. Bonhoeffer, J.M. Buettcher, M. Gambon, M. Heininger, U. Mueller, B. Schaad, U.B. Schuetz, P. Trachsel, D. |
| description | Standard inflammatory markers and chest radiography lack the ability to discriminate bacterial from non-bacterial lower respiratory tract infection (LRTI). Cytokine profiles may serve as biomarkers for LRTI, but their applicability to identify aetiology, severity of disease and need for antibiotic prescription in children remains poorly defined. Objectives were to determine the cytokine kinetic profiles over 5 days in paediatric patients with LRTI, to investigate the relationship between cytokine patterns, and clinical and laboratory variables.
We included patients aged 1 month to 18 years, with febrile LRTI and three consecutive cytokines measurements on days 1, 3 and 5 of a randomized controlled trial (ProPAED study). We evaluated differences in cytokine concentrations between days and associations with clinical and laboratory variables.
A total of 181 patients (median age 4.1 years) were included; 72/181 (40%) received antibiotics. Serum concentrations of interferon (IFN)-γ, interleukin (IL)-1ra, IL-6, IL-10, IFN-γ-inducible protein (IP)-10 and tumor necrosis factor-α were elevated on day 1 and decreased subsequently, with the greatest decline between day 1 and 3 (by −8 to >−94%). Procalcitonin (PCT) and C-reactive protein (CRP) values showed a protracted decrease with the most prominent reduction in concentrations between days 3 and 5. Significantly elevated IL-6 concentrations were associated with hospital admission, antibiotic treatment, and prolonged antibiotic treatment. Bacteraemic LRTI patients had higher concentrations of IL-1ra (p |
| doi_str_mv | 10.1016/j.cmi.2018.03.016 |
| format | Article |
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We included patients aged 1 month to 18 years, with febrile LRTI and three consecutive cytokines measurements on days 1, 3 and 5 of a randomized controlled trial (ProPAED study). We evaluated differences in cytokine concentrations between days and associations with clinical and laboratory variables.
A total of 181 patients (median age 4.1 years) were included; 72/181 (40%) received antibiotics. Serum concentrations of interferon (IFN)-γ, interleukin (IL)-1ra, IL-6, IL-10, IFN-γ-inducible protein (IP)-10 and tumor necrosis factor-α were elevated on day 1 and decreased subsequently, with the greatest decline between day 1 and 3 (by −8 to >−94%). Procalcitonin (PCT) and C-reactive protein (CRP) values showed a protracted decrease with the most prominent reduction in concentrations between days 3 and 5. Significantly elevated IL-6 concentrations were associated with hospital admission, antibiotic treatment, and prolonged antibiotic treatment. Bacteraemic LRTI patients had higher concentrations of IL-1ra (p <0.0055) and IL-6 (p <0.0055) on day 1.
We observed an earlier decrease of elevated cytokines compared to PCT or CRP. Both pro- and anti-inflammatory cytokines may serve as markers for severity of LRTI.</description><identifier>ISSN: 1198-743X</identifier><identifier>EISSN: 1469-0691</identifier><identifier>DOI: 10.1016/j.cmi.2018.03.016</identifier><identifier>PMID: 29555393</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Anti-Bacterial Agents - therapeutic use ; Antibacterial agents ; Bacteremia - diagnosis ; Bacteremia - immunology ; Bacteremia - microbiology ; bacterial infections ; Biomarkers - blood ; C-Reactive Protein - analysis ; Calcitonin - blood ; Calcitonin Gene-Related Peptide - blood ; Child ; Child, Preschool ; cytokines ; Cytokines - blood ; Cytokines - immunology ; Female ; Humans ; Immune system ; Infant ; Male ; paediatrics ; Protein Precursors - blood ; Respiratory Tract Infections - blood ; Respiratory Tract Infections - diagnosis ; Respiratory Tract Infections - drug therapy ; Respiratory Tract Infections - immunology ; Tumor Necrosis Factor-alpha - blood</subject><ispartof>Clinical microbiology and infection, 2018-12, Vol.24 (12), p.1341.e1-1341.e7</ispartof><rights>2018 European Society of Clinical Microbiology and Infectious Diseases</rights><rights>Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-6121d78cb79fd329ddb2543bc0b3deae6f494686755950a7752e3d0e13eaa3303</citedby><cites>FETCH-LOGICAL-c396t-6121d78cb79fd329ddb2543bc0b3deae6f494686755950a7752e3d0e13eaa3303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29555393$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fuchs, A.</creatorcontrib><creatorcontrib>Gotta, V.</creatorcontrib><creatorcontrib>Decker, M.-L.</creatorcontrib><creatorcontrib>Szinnai, G.</creatorcontrib><creatorcontrib>Baumann, P.</creatorcontrib><creatorcontrib>Bonhoeffer, J.</creatorcontrib><creatorcontrib>Ritz, N.</creatorcontrib><creatorcontrib>Baer, G.</creatorcontrib><creatorcontrib>Berthet, G.</creatorcontrib><creatorcontrib>Bonhoeffer, J.M.</creatorcontrib><creatorcontrib>Buettcher, M.</creatorcontrib><creatorcontrib>Gambon, M.</creatorcontrib><creatorcontrib>Heininger, U.</creatorcontrib><creatorcontrib>Mueller, B.</creatorcontrib><creatorcontrib>Schaad, U.B.</creatorcontrib><creatorcontrib>Schuetz, P.</creatorcontrib><creatorcontrib>Trachsel, D.</creatorcontrib><creatorcontrib>the ProPAED study group</creatorcontrib><creatorcontrib>ProPAED study group</creatorcontrib><title>Cytokine kinetic profiles in children with acute lower respiratory tract infection: a post hoc descriptive analysis from a randomized control trial</title><title>Clinical microbiology and infection</title><addtitle>Clin Microbiol Infect</addtitle><description>Standard inflammatory markers and chest radiography lack the ability to discriminate bacterial from non-bacterial lower respiratory tract infection (LRTI). Cytokine profiles may serve as biomarkers for LRTI, but their applicability to identify aetiology, severity of disease and need for antibiotic prescription in children remains poorly defined. Objectives were to determine the cytokine kinetic profiles over 5 days in paediatric patients with LRTI, to investigate the relationship between cytokine patterns, and clinical and laboratory variables.
We included patients aged 1 month to 18 years, with febrile LRTI and three consecutive cytokines measurements on days 1, 3 and 5 of a randomized controlled trial (ProPAED study). We evaluated differences in cytokine concentrations between days and associations with clinical and laboratory variables.
A total of 181 patients (median age 4.1 years) were included; 72/181 (40%) received antibiotics. Serum concentrations of interferon (IFN)-γ, interleukin (IL)-1ra, IL-6, IL-10, IFN-γ-inducible protein (IP)-10 and tumor necrosis factor-α were elevated on day 1 and decreased subsequently, with the greatest decline between day 1 and 3 (by −8 to >−94%). Procalcitonin (PCT) and C-reactive protein (CRP) values showed a protracted decrease with the most prominent reduction in concentrations between days 3 and 5. Significantly elevated IL-6 concentrations were associated with hospital admission, antibiotic treatment, and prolonged antibiotic treatment. Bacteraemic LRTI patients had higher concentrations of IL-1ra (p <0.0055) and IL-6 (p <0.0055) on day 1.
We observed an earlier decrease of elevated cytokines compared to PCT or CRP. 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Gotta, V. ; Decker, M.-L. ; Szinnai, G. ; Baumann, P. ; Bonhoeffer, J. ; Ritz, N. ; Baer, G. ; Berthet, G. ; Bonhoeffer, J.M. ; Buettcher, M. ; Gambon, M. ; Heininger, U. ; Mueller, B. ; Schaad, U.B. ; Schuetz, P. ; Trachsel, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-6121d78cb79fd329ddb2543bc0b3deae6f494686755950a7752e3d0e13eaa3303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibacterial agents</topic><topic>Bacteremia - diagnosis</topic><topic>Bacteremia - immunology</topic><topic>Bacteremia - microbiology</topic><topic>bacterial infections</topic><topic>Biomarkers - blood</topic><topic>C-Reactive Protein - analysis</topic><topic>Calcitonin - blood</topic><topic>Calcitonin Gene-Related Peptide - blood</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>cytokines</topic><topic>Cytokines - blood</topic><topic>Cytokines - immunology</topic><topic>Female</topic><topic>Humans</topic><topic>Immune system</topic><topic>Infant</topic><topic>Male</topic><topic>paediatrics</topic><topic>Protein Precursors - blood</topic><topic>Respiratory Tract Infections - blood</topic><topic>Respiratory Tract Infections - diagnosis</topic><topic>Respiratory Tract Infections - drug therapy</topic><topic>Respiratory Tract Infections - immunology</topic><topic>Tumor Necrosis Factor-alpha - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fuchs, A.</creatorcontrib><creatorcontrib>Gotta, V.</creatorcontrib><creatorcontrib>Decker, M.-L.</creatorcontrib><creatorcontrib>Szinnai, G.</creatorcontrib><creatorcontrib>Baumann, P.</creatorcontrib><creatorcontrib>Bonhoeffer, J.</creatorcontrib><creatorcontrib>Ritz, N.</creatorcontrib><creatorcontrib>Baer, G.</creatorcontrib><creatorcontrib>Berthet, G.</creatorcontrib><creatorcontrib>Bonhoeffer, J.M.</creatorcontrib><creatorcontrib>Buettcher, M.</creatorcontrib><creatorcontrib>Gambon, M.</creatorcontrib><creatorcontrib>Heininger, U.</creatorcontrib><creatorcontrib>Mueller, B.</creatorcontrib><creatorcontrib>Schaad, U.B.</creatorcontrib><creatorcontrib>Schuetz, P.</creatorcontrib><creatorcontrib>Trachsel, D.</creatorcontrib><creatorcontrib>the ProPAED study group</creatorcontrib><creatorcontrib>ProPAED study group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical microbiology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fuchs, A.</au><au>Gotta, V.</au><au>Decker, M.-L.</au><au>Szinnai, G.</au><au>Baumann, P.</au><au>Bonhoeffer, J.</au><au>Ritz, N.</au><au>Baer, G.</au><au>Berthet, G.</au><au>Bonhoeffer, J.M.</au><au>Buettcher, M.</au><au>Gambon, M.</au><au>Heininger, U.</au><au>Mueller, B.</au><au>Schaad, U.B.</au><au>Schuetz, P.</au><au>Trachsel, D.</au><aucorp>the ProPAED study group</aucorp><aucorp>ProPAED study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cytokine kinetic profiles in children with acute lower respiratory tract infection: a post hoc descriptive analysis from a randomized control trial</atitle><jtitle>Clinical microbiology and infection</jtitle><addtitle>Clin Microbiol Infect</addtitle><date>2018-12</date><risdate>2018</risdate><volume>24</volume><issue>12</issue><spage>1341.e1</spage><epage>1341.e7</epage><pages>1341.e1-1341.e7</pages><issn>1198-743X</issn><eissn>1469-0691</eissn><abstract>Standard inflammatory markers and chest radiography lack the ability to discriminate bacterial from non-bacterial lower respiratory tract infection (LRTI). Cytokine profiles may serve as biomarkers for LRTI, but their applicability to identify aetiology, severity of disease and need for antibiotic prescription in children remains poorly defined. Objectives were to determine the cytokine kinetic profiles over 5 days in paediatric patients with LRTI, to investigate the relationship between cytokine patterns, and clinical and laboratory variables.
We included patients aged 1 month to 18 years, with febrile LRTI and three consecutive cytokines measurements on days 1, 3 and 5 of a randomized controlled trial (ProPAED study). We evaluated differences in cytokine concentrations between days and associations with clinical and laboratory variables.
A total of 181 patients (median age 4.1 years) were included; 72/181 (40%) received antibiotics. Serum concentrations of interferon (IFN)-γ, interleukin (IL)-1ra, IL-6, IL-10, IFN-γ-inducible protein (IP)-10 and tumor necrosis factor-α were elevated on day 1 and decreased subsequently, with the greatest decline between day 1 and 3 (by −8 to >−94%). Procalcitonin (PCT) and C-reactive protein (CRP) values showed a protracted decrease with the most prominent reduction in concentrations between days 3 and 5. Significantly elevated IL-6 concentrations were associated with hospital admission, antibiotic treatment, and prolonged antibiotic treatment. Bacteraemic LRTI patients had higher concentrations of IL-1ra (p <0.0055) and IL-6 (p <0.0055) on day 1.
We observed an earlier decrease of elevated cytokines compared to PCT or CRP. Both pro- and anti-inflammatory cytokines may serve as markers for severity of LRTI.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29555393</pmid><doi>10.1016/j.cmi.2018.03.016</doi><oa>free_for_read</oa></addata></record> |
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| issn | 1198-743X 1469-0691 |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Adolescent Anti-Bacterial Agents - therapeutic use Antibacterial agents Bacteremia - diagnosis Bacteremia - immunology Bacteremia - microbiology bacterial infections Biomarkers - blood C-Reactive Protein - analysis Calcitonin - blood Calcitonin Gene-Related Peptide - blood Child Child, Preschool cytokines Cytokines - blood Cytokines - immunology Female Humans Immune system Infant Male paediatrics Protein Precursors - blood Respiratory Tract Infections - blood Respiratory Tract Infections - diagnosis Respiratory Tract Infections - drug therapy Respiratory Tract Infections - immunology Tumor Necrosis Factor-alpha - blood |
| title | Cytokine kinetic profiles in children with acute lower respiratory tract infection: a post hoc descriptive analysis from a randomized control trial |
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