Relationship between serum TNF-α, IL-6, and IL- 10 levels and disease severity, and changes in the cytokines after treatment in patients with bacterial community-acquired pneumonia

INTRODUCTION The role of some cytokines, such as interleukin (IL) and tumor necrosis factor-alpha (TNF-alpha), in serum in community-acquired pneumonia (CAP) has been mentioned. There are few results on changes in serum cytokines in patients with bacterial CAP. This study aimed at the relationship between serum TNF-alpha, IL-6, and IL-10 levels, disease severity, and changes in serum cytokines in patients with bacterial CAP.METHODS A descriptive follow-up study was conducted on 78 hospitalized patients with CAP. Serum IL-6, IL-10, and TNF-alpha levels were measured by fluorescence covalent microbead immunosorbent assay technique. Changes in serum cytokine levels were measured on admission's first and seventh day.RESULTS TNF-alpha, IL-6, and IL-10 medians were 0.76, 2.15, and 1.18 pg/ mL, respectively. There was no difference in interleukin levels between the two groups, namely those aged <65 years and those aged >= 65 years (p>0.05). The levels of IL-10 in patients with Gram-positive bacteria pneumonia were significantly higher than those with Gram-negative bacteria (2.23 pg/mL vs 1.15 pg/mL, respectively, p=0.03). Logistic regression analysis revealed that IL-10 (OR=0.92; 95% CI: 0.86-0.99, p=0.03) was associated with the prognosis of disease severity. IL-6 levels decreased statistically on day 7 after treatment (1.12 pg/mL vs 2.15 pg/mL, p=0.003). The change in TNF-alpha and IL-10 after treatment was not significant (p>0.05).CONCLUSIONS Serum IL-10 levels during hospitalization time are related to the prognosis of disease severity. After 7 days of treatment, IL-6 levels decreased statistically; however, TNF-alpha and IL-10 levels did not change.