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Molecular Inflammatory Responses Measured in Blood of Patients with Severe Community-Acquired Pneumonia

机译：严重社区获得性肺炎患者血液中的分子炎症反应测定

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In order to analyze the characteristics of the inflammatory response occurring in blood during pneumonia, we studied 38 patients with severe community-acquired pneumonia. Venous and arterial blood samples were collected at study entry and on days 1, 2, 3, 5, and 7 after inclusion. The concentrations of proinflammatory (tumor necrosis factor alpha [TNF-α], interleukin 1β [IL-1β], IL-6, and IL-8) and anti-inflammatory (IL-10) cytokines were determined in order to detect differences related to the origin of the sample, the causative organism, the clinical variables, and the final outcome of the episode. Legionella pneumonia infections showed higher concentrations of TNF-α, IL-6, IL-8, and IL-10. After 24 h, plasma IL-6, IL-8, and IL-10 concentrations in pneumococcal episodes increased, whereas in the same time interval, cytokine concentrations in Legionella episodes markedly decreased. The characteristics of the inflammatory response in bacteremic pneumococcal episodes were different from those in nonbacteremic episodes, as indicated by the higher plasma cytokine concentrations in the former group. Finally, our analysis of cytokine concentrations with regard to the outcome—in terms of the need for intensive care unit admittance and/or mechanical ventilation as well as mortality—suggests that there is a direct relationship between the intensity of the inflammatory response measured in blood and the severity of the episode.
机译：为了分析肺炎期间血液中发生的炎症反应的特征，我们研究了38例严重的社区获得性肺炎患者。在研究进入时和入选后第1、2、3、5和7天收集静脉和动脉血样品。测定促炎（肿瘤坏死因子α[TNF-α]，白介素1β[IL-1β]，IL-6和IL-8）和抗炎（IL-10）细胞因子的浓度，以检测相关的差异样本的来源，致病菌，临床变量以及发作的最终结果。 Legionella 肺炎感染表现出较高的TNF-α，IL-6，IL-8和IL-10浓度。 24小时后，肺炎球菌发作时血浆IL-6，IL-8和IL-10浓度升高，而在同一时间间隔内， Legionella 发作中的细胞因子浓度明显降低。细菌性肺炎球菌发作中的炎症反应特征与非细菌性发作中的炎症反应特征不同，前者的血浆细胞因子浓度更高。最后，我们根据结果对细胞因子浓度的分析（就重症监护病房入院和/或机械通气的需要以及死亡率而言）建议，血液中测得的炎症反应强度之间存在直接关系和情节的严重性。

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