Temporal changes in cytokine/chemokine profiles and pulmonary involvement in severe acute respiratory syndrome

Respirology. 2006 Nov;11(6):715-22. doi: 10.1111/j.1440-1843.2006.00942.x.


Objective and background: Pathological changes in severe acute respiratory syndrome (SARS) suggest that SARS sequelae are associated with dysregulation of cytokine and chemokine production. To improve understanding of the immuno-pathological processes involved in lung injury associated with SARS, the temporal changes in cytokine/chemokine profiles in the sera of SARS patients were compared with those of patients with community-acquired pneumonia (CAP), according to the degree of lung involvement.

Methods: Serum levels of 11 cytokines and chemokines, in 14 patients with SARS and 24 patients with CAP, were serially checked using a bead-based multiassay system. Sera from 12 healthy subjects were used as normal controls.

Results: The serum levels of interferon-gamma-inducible protein-10 (IP-10), IL-2 and IL-6 were significantly elevated during SARS infection. In patients with CAP, but not in those with SARS, the levels of interferon-gamma, IL-10, IL-8 and monokine induced by interferon-gamma (MIG) were significantly elevated compared with the levels in healthy controls. Among the chemokines/cytokines, IL-6 levels correlated most strongly with radiographic scores (r=0.62). The elevation of IP-10 and IL-2 antedated the development of chest involvement and reached peak levels earlier than the radiographic scores. In contrast, the dynamic changes in IL-6, C-reactive protein and neutrophils occurred synchronously with the changes in radiographic scores. The mean ratio of IL-6 to IL-10 in SARS patients (4.84; range 0.41-21) was significantly higher than that in CAP patients (2.95; range 0.02-10.57) (P=0.04).

Conclusions: The early induction of IP-10 and IL-2, as well as the subsequent over-production of IL-6 and lack of IL-10 production, probably contribute to the main immuno-pathological processes involved in lung injury in SARS. These changes in cytokine/chemokine profile are remarkably different from those observed in CAP patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Chemokine CXCL10
  • Chemokines / blood*
  • Chemokines / genetics
  • Chemokines, CXC / genetics
  • Chemokines, CXC / metabolism
  • Community-Acquired Infections / blood
  • Community-Acquired Infections / diagnostic imaging
  • Community-Acquired Infections / immunology
  • Community-Acquired Infections / physiopathology
  • Cytokines / blood*
  • Cytokines / genetics
  • Female
  • Gene Expression Regulation
  • Humans
  • Interleukin-10 / genetics
  • Interleukin-10 / metabolism
  • Interleukin-2 / genetics
  • Interleukin-2 / metabolism
  • Interleukin-6 / genetics
  • Interleukin-6 / metabolism
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Male
  • Middle Aged
  • Pneumonia / blood
  • Pneumonia / diagnostic imaging
  • Pneumonia / immunology
  • Pneumonia / physiopathology
  • Prospective Studies
  • Radiography
  • Severe Acute Respiratory Syndrome / blood
  • Severe Acute Respiratory Syndrome / diagnostic imaging
  • Severe Acute Respiratory Syndrome / immunology*
  • Severe Acute Respiratory Syndrome / physiopathology*


  • Chemokine CXCL10
  • Chemokines
  • Chemokines, CXC
  • Cytokines
  • Interleukin-2
  • Interleukin-6
  • Interleukin-10