Interleukin-6 and Its Relationship to C-Reactive Protein and Fever in Children with Febrile Neutropenia

Heney, David; Lewis, I; Evans, Stuart; Banks, Rosamonde E.; Bailey, Chris; Whicher, J T

doi:10.1093/infdis/165.5.886

Cited by 93 publications

(48 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It should be noted that, on any day of the study, all patients with FUO had slightly higher procalcitonin levels than did healthy subjects. Unlike concentrations of IL-6 [3],…”

Section: Service De Médecine Interne and Laboratoire De Biochimiementioning

confidence: 95%

Procalcitonin as an Early Marker of Bacterial Infection in Severely Neutropenic Febrile Adults

Bernard¹,

Ferrière²,

Casassus³

et al. 1998

CLIN INFECT DIS

View full text Add to dashboard Cite

“…It should be noted that, on any day of the study, all patients with FUO had slightly higher procalcitonin levels than did healthy subjects. Unlike concentrations of IL-6 [3],…”

Section: Service De Médecine Interne and Laboratoire De Biochimiementioning

confidence: 95%

Procalcitonin as an Early Marker of Bacterial Infection in Severely Neutropenic Febrile Adults

Bernard¹,

Ferrière²,

Casassus³

et al. 1998

CLIN INFECT DIS

View full text Add to dashboard Cite

“…Elevated levels of serum cytokines have been found in relation to surgery and trauma [28], and in patients with sepsis [18]. Elevated levels of cytokines in other serious diseases in infants and children [29], or in myeloma in adults [30], have been found. To our knowledge high cytokine levels have not been reported earlier in healthy individuals, and there is little or no information about defective production in certain individuals.…”

Section: Dlsctsslonmentioning

confidence: 99%

Cytokines in nasopharyngeal secretions; evidence for defective IL-1β production in children with recurrent episodes of acute otitis media

Lindberg

Rynnel-Dagöö

Sundqvist

1994

Clinical and Experimental Immunology

View full text Add to dashboard Cite

SUMMARYThe host-parasite relationship in the nasopharynx of young children with bacterial colonization and antigen uptake in the mucosa and lymphatic tissue provides an opportunity to investigate infectious inflammatory processes and responses. IL-l/:i, IL-6 and tumour necrosis factor-alpha (TNF-rt) were analysed in nasopharyngeal secretions and serum from children with or without recurrent episodes of acute otitis media, from healthy adults and adults with hypogammaglobulinaemia or selective deficiency of IgG3. Nasopharyngeal secretions generally contained substantial amounts of \L-\ii, IL-6 and TNF-a. In contrast. IL-1/'^. IL-6 and TNF-fv were not detectable in sera on the same occasion. Children were found to have higher levels of IL-1/3, IL-6 and TNF-rk than healthy adults and than adults with immunodeficiency. High levelsof IL-IJ were associated with low or undetectable levels of IL-6 and TNF-a, whereas the opposite pattern was seen in association with low levels of IL-l/l This was especially true for children with recurrent episodes of acute otitis media (RAOM). In children with nasopharyngeal colonization with Haemophilus infiuenzae, significantly higher levels of IL-1/3, IL-6 and TNF-o (P =00001. respectively) were found compared with non-colonized children. Notably, the RAOM children exhibited significantly lower levels of IL-I/i IL-6, and TNF-n in nasopharyngeal secretions {P = 0 0001, 0.01 and 0.0001, respectively) than healthy children. These results demonstrate local production of inflammatory cytokines in nasopharynx, related to bacterial colonization, and suggest that children with RAOM are poor nasopharyngeal cytokine producers.Keywords \L-\fl IL-6 tumour necrosis factor alpha nasopharyngeal secretions children INTRODLCTIONThe human nasopharynx plays a crucial role for development of immune responses to foreign microorganisms [1], and is a natural reservoir for several bacterial species, including Streptococcus pneumoniae, Haemophilus infiuenzae. the majority of which are non-typable [2]. and Moraxella (Branhamella) catarrhalis.Bacterial adherence to the mucosa is a well known phenomenon in children. Carriership of pneumococci has been monitored in several epidemiological studies, particularly in the age group 1 -2 years [3], where the colonization rate is about 90%. There is a subsequent decline in preschool children, and the colonization rate in adults is 10%. The epidemiology of nontypable H. infiuenzae is less well known, because of earlier difliculties in classifying this species. In one recent study the colonization rate was 35% in preschool children [4]. A decline with increasing age has also been demonstrated. Carriership is a Correspondence: Dr K. Lindberg. Department of Otorhinolaryngology. B5

show abstract

“…However, bone marrow toxicity as the result of chemotherapy leads to reduced numbers of leukocytes in cancer patients; this factor may be one of the reasons for the low total levels of TNF-␣ and IL-1␤ (8). At the same time, leukopenic cancer patients strikingly show distinct increases in plasma IL-8 and IL-6 levels during bacterial infections, suggesting that there may be sources other than leukocytes for IL-8 and IL-6 (5,9,11,12,15,20,22,23,30).…”

mentioning

confidence: 99%

Endothelial Cells Are Main Producers of Interleukin 8 through Toll-Like Receptor 2 and 4 Signaling during Bacterial Infection in Leukopenic Cancer Patients

Nijhuis

Vellenga²,

Daenen³

et al. 2003

Clin Vaccine Immunol

View full text Add to dashboard Cite

Cancer patients who are leukopenic due to chemotherapy are susceptible to bacterial infections. Normally, clinical conditions during bacterial infections are caused by pathogen-associated molecular patterns, which are components that bind to Toll-like receptor (TLR) 2 (TLR-2) and TLR-4 on leukocytes, resulting in the production of inflammatory cytokines. The mechanism of this inflammatory response in cancer patients with diminished numbers of leukocytes is not completely clear. The levels of interleukin 1␤ (IL-1␤) and tumor necrosis factor alpha measured in the circulation of leukopenic cancer patients are lower than those measured in that of nonleukopenic patients during bacterial infections, whereas plasma interleukin 8 (IL-8) levels show distinct identical increases during bacterial infections in both leukopenic and nonleukopenic patients. Normally, these cytokines are mainly secreted by leukocytes. In cancer patients with bacterial infections and a diminished number of leukocytes, other sources of IL-8 production, such as endothelial cells, might be expected. Endothelial cells instead of leukocytes become the most important producers of IL-8 during bacterial infections in patients with chemotherapy-induced leukopenia through TLR-2 and TLR-4 signaling. Whole blood samples from six cancer patients were stimulated with lipopolysaccharide (LPS), and then IL-8 concentrations in supernatants were measured. Further, human umbilical vein endothelial cells (HUVECs) were incubated with sera from leukopenic cancer patients with or without bacterial infections, and then IL-8 concentrations in supernatants were measured (n ‫؍‬ 6). In addition, the same HUVEC experiment was performed with the addition of neutralizing antibodies against TLR-2 and TLR-4. During leukopenia (<10 9 cells/liter), LPS stimulation of whole blood did not result in an increase in IL-8 levels. However, when endothelial cells were incubated with sera from leukopenic cancer patients during bacterial infections, a threeto eightfold increase in IL-8 production was found, compared to the IL-8 production found after incubation with sera from patients without signs of infections. This increase did not reflect a higher level of IL-8 already present in the sera. Further, we demonstrated that IL-8 production induced in endothelial cells by sera from patients with documented gram-negative infections could be reduced significantly by up to 40% when the cells were incubated with neutralizing antibodies against TLR-4 (P ‫؍‬ 0.028). The addition of TLR-2 antibodies slightly enhanced the reduction of IL-8 production. These results suggest that during bacterial infections in cancer patients with markedly diminished numbers of leukocytes, endothelial cells become important producers of IL-8 through TLR-4 signaling and, to a lesser extent, TLR-2 signaling.

show abstract

Interleukin-6 and Its Relationship to C-Reactive Protein and Fever in Children with Febrile Neutropenia

Cited by 93 publications

References 14 publications

Procalcitonin as an Early Marker of Bacterial Infection in Severely Neutropenic Febrile Adults

Procalcitonin as an Early Marker of Bacterial Infection in Severely Neutropenic Febrile Adults

Cytokines in nasopharyngeal secretions; evidence for defective IL-1β production in children with recurrent episodes of acute otitis media

Endothelial Cells Are Main Producers of Interleukin 8 through Toll-Like Receptor 2 and 4 Signaling during Bacterial Infection in Leukopenic Cancer Patients

Contact Info

Product

Resources

About