Inflammatory cytokine profile in children with severe acute respiratory syndrome.
Pediatrics
; 113(1 Pt 1): e7-14, 2004 Jan.
Article
em En
| MEDLINE
| ID: mdl-14702488
ABSTRACT
OBJECTIVE:
To study the inflammatory cytokine profile in children with severe acute respiratory syndrome (SARS) and to investigate whether monoclonal antibody to tumor necrosis factor-alpha (TNF-alpha) could be considered for treatment of these patients.METHODS:
Plasma inflammatory cytokine concentrations (interleukin [IL]-1beta, IL-6, IL-8, IL-10, IL-12p70, and TNF-alpha) were monitored longitudinally on admission, immediately before corticosteroids, and 1 to 2 days and 7 to 10 days after the drug treatment in a cohort of pediatric patients (n = 8) with virologic confirmed SARS-associated coronavirus infection. None of the patients required mechanical ventilation or intensive care treatment. All children except 1 (patient 3) received corticosteroids.RESULTS:
Plasma IL-1beta levels (excluding patient 3) were substantially elevated immediately before (range 7-721 ng/L) and 7 to 10 days after (range 7-664 ng/L) corticosteroid treatment. In contrast, the plasma concentrations of other key proinflammatory cytokines, including IL-6 and TNF-alpha, were not overtly increased in any of the patients throughout the course of illness. In addition, plasma IL-10 concentration was significantly lower 1 to 2 days and 7 to 10 days after corticosteroid treatment, compared with the immediate pretreatment level. Similarly, plasma IL-6 and IL-8 concentrations were significantly decreased 7 to 10 days after the drug treatment.CONCLUSIONS:
Pediatric SARS patients have markedly elevated circulating IL-1beta levels, which suggests selective activation of the caspase-1-dependent pathway. Other key proinflammatory cytokines, IL-6 and TNF-alpha, showed only mildly elevated levels at the initial phase of the illness. The current evidence does not support the use of TNF-alpha monoclonal antibody in this group of children.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Monocinas
/
Corticosteroides
/
Síndrome Respiratória Aguda Grave
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Pediatrics
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Hong Kong