Abstract
The aim of study was to study of cytokine production levels and their relationship in the mechanisms of regulation of the inflammatory process in community-acquired pneumonia.
 Materials and methods. The study was carried out in the period 2017–2020 based on the therapeutic department of the Municipal non-profit enterprise “City Clinical Multidisciplinary Hospital No. 25” of Kharkiv City Council. The study involved 34 adult patients with CAP aged 18 to 80 years (mean age 36.5±10.3). The control group consisted of 20 apparently healthy individuals (mean age 39.5±12.5). Levels of IL-17, IL-1Ra, TGFβ1, visfatin, adiponectin were determined by enzyme-linked immunosorbent assay.
 Results. Levels of IL-1 Ra and IL-17 in the group of patients with САP were 3.77±0.24 and 33.08±0.10 pg/ml, respectively. In the PРI group, the level of these indicators was probably higher (p<0.05) and was 2.53±0.13 and 28.17±0.53 pg/ml. The level of TGFβ1 in the group of patients with CAP was 24.54±0.55 ng/ml and was slightly higher than in the group of AHI (26.33±0.62 ng/ml). No differences were found between adiponectin levels in the AHI group and patients with CAP, as in the case of visfatin levels. The disappearance of relationships in the system of normal regulation of the inflammatory process between one pair of cytokines and their appearance between other pairs indicates a violation of regulatory mechanisms in patients with community-acquired pneumonia.
 Conclusions. The identified characteristics of the cytokine profile reflect the end of the phase of active inflammation in the lungs and the beginning of the phase of compensatory reactions. The findings suggest the importance of studying the cytokine profile in patients with community-acquired pneumonia, which will help to develop new approaches to predict the course of pneumonia, ways to correct metabolic disorders that develop in this condition, and will help identify risk groups for this pathology
Highlights
Community-acquired pneumonia (CAP) remains one of the most pressing problems of modern medicine, primarily due to the consistently high incidence
It could be assumed that changes in the cytokine profile in patients with CAP are associated with the beginning of the transition of the already started process, initiated by inflammation, in the phase of compensatory reactions
The increase in the level of IL-17 confirms the development of inflammation, which was induced by alteration [5, 8]
Summary
Community-acquired pneumonia (CAP) remains one of the most pressing problems of modern medicine, primarily due to the consistently high incidence. According to the WHO in recent years, lower respiratory tract infections are the third leading cause of death on the planet [1]. The mortality rate in hospitalized patients with severe disease varies from 14 to 40 % and increases significantly among patients older than 60 years [2, 3]. An important place in the study of molecular mechanisms of pathogenesis of CAP is occupied by intercellular mediators, which play a key role in this process [1, 2]. Interleukin 1 receptor antagonist (IL-1Ra) is one of the most important anti-inflammatory factors. It is part of a biological multisystem – a cytokine network that performs intercellular interactions that maintain cellular homeostasis at a certain level. IL-1Ra blocks the cellular receptor specific for IL-1α and IL-1β [4]
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