Features of cytokine production in patients with bacterial pneumonia with underlying acute respiratory viral infection

INTRODUCTION: Pneumonia is one of the most common inflammatory diseases of the lower airways associated with a high risk of development of life-threatening complications, the effective correction of which requires taking into account the peculiarities of inflammatory response of an organism, in particular, determination of cytokine production. AIM: To study the peculiarities of cytokine and inflammatory effector molecule production in patients with community-acquired pneumonia (CAP) with the underlying acute respiratory viral co-infection. MATERIALS AND METHODS: A total of 85 patients of both genders aged 18 to 33 years with bacterial CAP were examined, including 30 patients without signs of acute respiratory viral infection (ARVI), 55 patients with ARVI in the first 3 days of illness, and 25 practically healthy individuals. In the venous blood serum, the concentration of interleukins (IL) IL-1β, -2, -4, -8, -10, -11, -12, -13, -15, -18, -17A, -20, -23, -24, -28A, -33, interleukin-1 receptor antagonist, tumor necrosis factor α (TNFα), interferons (IFN): IFNα and IFNγ, macrophage inflammatory protein 3α (MIP3α), monocyte chemoattractant protein 1, granulocyte colony-stimulating growth factor, transforming growth factor β, basic fibroblast growth factor (bFGF), vascular endothelial growth factor A, soluble form of type 1 receptor to VEGF-A, soluble form type 1 receptor to TNFα, were determined. RESULTS: In patients with mild CAP with added ARVI, the greatest increase was noted in production of IL-17A compared to patients without ARVI (р = 0.043). At the same time, production of MIP3α decreased by 13.7% (р = 0.01). In severe CAP with the underlying ARVI, production of IL-1β changed to a greater extent, increasing by 31.6% (р = 0.039), with the underlying 25.0% decrease in production of MIP3α (р = 0.05) and bFGF (р = 0.039). In patients with mild CAP compared to ARVI, production of IFNα decreased by 104.9% (р = 0.001), with the underlying increase in IL-17A by 63.8% (р = 0.001). Severe CAP, compared with ARVI, was characterized by a decrease in production of IFNα by 65.8% (р = 0.0001), with the underlying increase in the level of IL-17A by 69.9% (р = 0.0001). CONCLUSIONS: The addition of acute viral infection in patients with bacterial CAP promotes a change in the cytokine profile of blood serum, evidencing a modification of the immune response in such patients, probably, due to a change in the activity of macrophages and T-helpers.