Interleukin-6 and granulocyte colony-stimulating factor as predictors of the prognosis of influenza-associated pneumonia

Abstract

Background Pneumonia is a common complication of influenza and closely related to mortality in influenza patients. The present study examines cytokines as predictors of the prognosis of influenza-associated pneumonia. Methods This study included 101 inpatients with influenza (64 pneumonia and 37 non-pneumonia patients). 48 cytokines were detected in the serum samples of the patients and the clinical characteristics were analyzed. The correlation between them was analyzed to identify predictive biomarkers for the prognosis of influenza-associated pneumonia. Results Seventeen patients had poor prognosis and developed pneumonia. Among patients with influenza-associated pneumonia, the levels of 8 cytokines were significantly higher in those who had a poor prognosis: interleukin-6 (IL-6), interferon-γ (IFN-γ), granulocyte colony-stimulating factor (G-CSF), monocyte colony-stimulating factor (M-CSF), monocyte chemoattractant protein-1 (MCP-1), monocyte chemoattractant protein-3, Interleukin-2 receptor subunit alpha and Hepatocyte growth factor. Correlation analysis showed that the IL-6, G-CSF, M-CSF, IFN-γ, and MCP-1 levels had positive correlations with the severity of pneumonia. IL-6 and G-CSF showed a strong and positive correlation with poor prognosis in influenza-associated pneumonia patients. The combined effect of the two cytokines resulted in the largest area (0.926) under the receiver-operating characteristic curve. Conclusion The results indicate that the probability of poor prognosis in influenza patients with pneumonia is significantly increased. IL-6, G-CSF, M-CSF, IFN-γ, and MCP-1 levels had a positive correlation with the severity of pneumonia. Importantly, IL-6 and G-CSF were identified as significant predictors of the severity of influenza-associated pneumonia.

Serum Cytokines Predict Neurological Damage in Genetically Diverse Mouse Models

“…IL-4 and IL-5 have been associated with positive outcomes to infection by Hepatitis B virus [67] and influenza [68] and aid in the clinical recovery of experimental autoimmune encephalomyelitis (EAE) models [69] of multiple sclerosis. Significant differences in G-CSF levels in control and infected females and males, for both time points, could indicate differences in the degree of overall inflammation (e.g., [70]). Gender differences in levels of G-CSF are not widely reported but could have far-reaching implications; therefore, this finding is worth further investigation.…”

Involvement of Dectin-2 in the Innate Inflammatory Response Triggered by Influenza Virus Hemagglutinin

“…These results indicate that Dectin-2 may be closely involved in viral phagocytosis by alveolar macrophages and elimination by the mobilization of innate lymphoid cells (ILCs) during IFV infection. Conversely, in humans, proinflammatory cytokines such as IL-6 and IFN-γ in serum were increased significantly in patients who developed pneumonia during IFV infection compared with serum from patients without pneumonia, suggesting that serum cytokine dynamics are associated with prognosis in influenza-related pneumonia[35]. Therefore, the present research raises the possibility that reduced IL-6 production under Dectin-2 deficiency may affect suppression of the severity of pneumonia caused by harmful cytokine storms.…”

Treatment with lipoxin A 4 improves influenza A infection outcome through macrophage reprogramming, anti-inflammatory and pro-resolutive responses

“…Severe cases of IAV infection are marked by exuberant cytokine production with persistent innate immune cell in ltration and an exuberant T cell response 71 . Serum samples of patients with in uenzaassociated pneumonia showed a positive correlation between poor prognosis and elevated levels of IL-6, IFN-γ and G-CSF 72 . In mice, the production of those cytokines was also correlated with persistent neutrophil survival and in ltration, along with increased tissue damage 44,73 .…”