Cytokine Kinetics in Febrile Neutropenic Children: Insights on the Usefulness as Sepsis Biomarkers, Influence of Filgrastim, and Behavior of the IL-23/IL-17 Pathway.

Autor: de Araujo OR; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Instituto de Oncologia Pediatrica (IOP), Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 572-Vila Clementino, 04039-001 São Paulo, SP, Brazil., Salomão R; Division of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 669, 10th Floor, 04039-001 São Paulo, SP, Brazil., Brunialti MKC; Division of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 669, 10th Floor, 04039-001 São Paulo, SP, Brazil., da Silva DCB; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Instituto de Oncologia Pediatrica (IOP), Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 572-Vila Clementino, 04039-001 São Paulo, SP, Brazil., Senerchia AA; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Instituto de Oncologia Pediatrica (IOP), Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 572-Vila Clementino, 04039-001 São Paulo, SP, Brazil., de Moraes Costa Carlesse FA; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Instituto de Oncologia Pediatrica (IOP), Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 572-Vila Clementino, 04039-001 São Paulo, SP, Brazil., Petrilli AS; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Instituto de Oncologia Pediatrica (IOP), Sao Paulo Federal University (UNIFESP), Rua Pedro de Toledo 572-Vila Clementino, 04039-001 São Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: Mediators of inflammation [Mediators Inflamm] 2017; Vol. 2017, pp. 8291316. Date of Electronic Publication: 2017 Jul 09.
DOI: 10.1155/2017/8291316
Abstrakt: Background: The study aimed to describe the kinetics of various cytokines from day 1 to day 14 of the onset of fever in neutropenic children and to evaluate their performances as discriminators of sepsis in the first 24 hours of fever, the possible influence of filgrastim, and the functioning of the IL-23/IL-17 axis.
Methods: IL-1 β , TNF- α , IL-10, IL-12/23p40, IL-21, IL-6, IL-8, IL-17, G-CSF, and GM-CSF were measured in plasma on days 1, 2, 3, 5, and 14 from the onset of fever in 35 patients.
Results: Thirteen patients (37.1%) developed sepsis. In mixed models, IL-6, IL-8, IL-10, and G-CSF showed higher estimated means in septic patients ( P < 0.005), and IL-12/23p40 and IL-17 in nonseptic patients ( P < 0.05). On day 1, IL-6, IL-8, and IL-10 appeared upregulated in patients who received filgrastim. Only IL-6, IL-8, IL-10, and procalcitonin were useful as discriminators of sepsis. Associating the markers with each other or to a risk assessment model improved performance.
Conclusions: Cytokines kinetics showed proinflammatory and anti-inflammatory responses similar to what is described in nonneutropenic patients. IL-8, IL-6, IL-10, and procalcitonin are useful as early biomarkers of sepsis. Filgrastim upregulates expression of these markers, and we observed deficiency in the IL-23-IL-17 axis accompanying sepsis.
Databáze: MEDLINE
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