Tumor Necrosis Factor-α and Interleukin-10 in Viral and Bacterial Gastroenteritis in Children

Abstract

Gastroenteritis is a common cause of hospitalization and is associated with high morbidity in children. C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) are primary mediators of inflammation, and have been implicated in many infectious and non-infectious inflammatory diseases. The main objective of this study was to identify serum markers in viral and bacterial gastroenteritis. Thirty-one patients admitted to a pediatric infection ward with gastroenteritis and definite pathogens were enrolled in the study: 17 patients had viral gastroenteritis and 14 bacterial gastroenteritis. Serum levels of TNF-alpha, IL-10 and CRP were measured in these 31 patients, and in a control group of 15 healthy children. Serum concentrations of TNF-alpha and CRP were significantly greater in patients with bacterial gastroenteritis than in patients with viral gastroenteritis and healthy controls (p < 0.001). Concentrations of IL-10 were increased, but not significantly, in patients with viral or bacterial gastroenteritis (p = 0.577 vs controls). Regarding diagnosis, the measurement of TNF-alpha and CRP levels was 78.6% and 92.0% sensitive, respectively; and 88.2% and 58.8% specific, respectively. Serum TNF-alpha concentration may be a useful marker for distinguishing between viral and bacterial gastroenteritis.