Heightened Local Th17 Cell Inflammation Is Associated with Severe Community-Acquired Pneumonia in Children under the Age of 1 Year.

Ming Liu,Tao Ding,Diyuan Yang,Gen Lu,Yiping Xu,Yue Li,Hai-Bin Luo,Ping Wang,Bingtai Lu,Xiaoqiong Gu,Shuling Du,Yunfeng Liu,Huifeng Fan,Di Che,Xuanjie Guo

doi:10.1155/2021/9955168

Ming Liu, Tao Ding + Show 13 more

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https://doi.org/10.1155/2021/9955168

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Severe community-acquired pneumonia (sCAP) early in life is a leading cause of morbidity, mortality, and irreversible sequelae. Herein, we report the clinical, etiological, and immunological characteristics of 62 children age < 1 year. We measured 27 cytokines in plasma and bronchoalveolar lavage (BAL) from 62 children age < 1 year who were diagnosed with CAP, and then, we analyzed correlations among disease severity, clinical parameters, and etiology. Of the entire cohort, three cytokines associated with interleukin-17- (IL-17-) producing helper T cells (Th17 cells), IL-1β, IL-6, and IL-17, were significantly elevated in sCAP patients with high fold changes (FCs); in BAL, these cytokines were intercorrelated and associated with blood neutrophil counts, Hb levels, and mixed bacterial-viral infections. BAL IL-1β (area under the curve (AUC) 0.820), BAL IL-17 (AUC 0.779), and plasma IL-6 (AUC 0.778) had remarkable predictive power for sCAP. Our findings revealed that increased local Th17 cell immunity played a critical role in the development of sCAP in children age < 1 year. Th17 cell-related cytokines could serve as local and systemic inflammatory indicators of sCAP in this age group.

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Community-acquired pneumonia (CAP) is the leading cause of morbidity and mortality in children under 5 years of age [1,2,3,4]
From January 2017 to January 2020, we evaluated 743 patients age < 1 year who were diagnosed with CAP at Guangzhou Women and Children’s Medical Center (GWCMC)
We investigated clinical characteristics of and inflammatory cytokines in plasma and bronchoalveolar lavage (BAL) from a cohort of 62 pneumonia patients age < 1 year

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Introduction

Community-acquired pneumonia (CAP) is the leading cause of morbidity and mortality in children under 5 years of age [1,2,3,4]. Consistent with the above findings, in our retrospective study involving 25,564 children ages 0–5 years diagnosed with CAP, most of the children were age < 1 year (59.0% of all patients), and this subgroup had the highest incidences of sCAP (70.5% of all severe cases) and mortality (76.6% of all mortalities; unpublished data). This prompted us to investigate the factors associated with sCAP in this age group

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