Dynamics of cytokines and role of immunocorrection in nosocomial pneumonia.

Vladimir P Kuznetsov, Elena V Markelova, Eugeniuya V Silich, Dmitry L Belyaev, Alla A Babayants, Svetlana Yu Kuznetsova
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Abstract

We have studied the changes in the serum level of the following cytokines during the course of treatment of nosocomial pneumonia (NP): pro-inflammatory--IL-1alpha and IL-6, chemoattractive--IL-8, anti-inflammatory--IL-4 and IL-10, and differentiating-activating--IFN-gamma and TNF-alpha. It has been found that at the time of admission of the patients the clinical severity of their condition was correlated with increased levels of all circulating cytokines except for IFN-gamma, the level of which was low. An adequate ethiotropic therapy helped to clear the clinical symptoms of infection and intoxication in 1-2 weeks. The level of circulating pro- and anti-inflammatory cytokines, IL-8, and TNF-alpha was decreasing, however, the level of IFN-gamma did not change significantly during 15 days. The ratio IFN-gamma/IL-10 did not change much but was slightly low during the treatment of the severe form of NP. Radical positive changes in the cytokine dynamics were achieved after the addition of leukinferon to the ethiotropic therapy.

院内肺炎患者细胞因子动态变化及免疫校正作用。
我们研究了院内肺炎(NP)治疗过程中血清中以下细胞因子水平的变化:促炎- il -1 α和IL-6,趋化-IL-8,抗炎-IL-4和IL-10,分化激活- ifn - γ和tnf - α。研究发现,在患者入院时,其病情的临床严重程度与除ifn - γ外的所有循环细胞因子水平升高相关,ifn - γ水平较低。适当的益硫治疗有助于在1-2周内清除感染和中毒的临床症状。循环中促炎和抗炎细胞因子、IL-8和tnf - α水平下降,但ifn - γ水平在15天内无显著变化。ifn - γ /IL-10比值在重度NP治疗期间变化不大,但略低。在嗜硫治疗中加入白细胞介素后,细胞因子动力学发生了激进的积极变化。
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