Cytokine expression in pediatric subperiosteal orbital abscesses

Background: Cytokines have been shown to play a key role in infectious and inflammatory processes. The purpose of the study was to characterize the pattern of cytokine expression in subperiosteal orbital abscesses associated with pediatric orbital cellulitis. Methods: All pediatric patients over a 5-month period who had orbital cellulitis and a subperiosteal abscess with an adjacent sinusitis requiring surgical drainage of the orbital abscess were given the opportunity to enroll in the study. A protein array membrane and a chemiluminescent detection system were used to identify the presence of 45 cytokines in the subperiosteal abscess fluid. Results: Four abscesses were analyzed with the protein array membrane. Of the 45 cytokines studied for this report, interleukin (IL)- I alpha, IL- I beta, IL-I receptor antagonist (ra), IL-6, tumor necrosis factor (TNF)-alpha, and TNF-beta were detected in all specimens. Additionally, IL- 16, epidermal growth factor related protein, and soluble TNF receptor 11 were detected in 3 of the 4 specimens. Interpretation: Pediatric orbital cellulitis with subperiosteal abscess is an inflammatory condition with a distinct pattern of cytokine expression. The detection of IL- 1, IL- I ra, IL-6, and TNF suggests that in the future these cytokines may play a role in monitoring disease activity or as potential targets for immunotherapy.