Complex assessment of clinical features and role of interleukin-10 g-1082a gene polymorphism in the development of slowly resolving clinical course of community-acquired pneumonia

Abstract

Aim. To perform a complex assessment of clinical, molecular and genetic factors in the development of slowly resolving pneumonia and to assess their diagnostic values. Methods. 95 patients with community-acquired pneumonia, of which 37 people had a prolonged clinical course of the disease, were examined. Interleukin-10 G-1082A gene polymorphism was evaluated in all patients by polymerase chain reaction. Logistic regression analysis was used for prognostic model construction. Results. Factors predisposing to the slowly resolving pneumonia were: concomitant chronic obstructive pulmonary disease, polymicrobial etiology, multilobar lung involvement, destructive lung lesions and presence of pleural effusion detected by X-Ray. The distribution of interleukin-10 G-1082A genotypes was consistent with Hardy-Weinberg equilibrium (χ2=3.62, p=0.057). There was a significant difference found in the symptoms and laboratory changes severity associated with interleukin-10 G-1082A gene polymorphism: patients carrying GA and AA genotypes had a milder clinical and laboratory changes and a milder course of the disease with fewer complications. Interleukin-10 -1082 GG genotype prevailed among patients with slowly resolving pneumonia. The complex use of clinical data, X-Ray findings and results of molecular and genetic typing allowed to reliably predict the course of the disease. Conclusion. The complex approach considering clinical and genetic features was the most successful for prognosis of slowly resolving pneumonia. The gained data can be used to predict the duration of community-acquired pneumonia course.