Cytokine Concentrations in Plasma from Children with Severe and Non-Severe Community Acquired Pneumonia

PLoS One. 2015 Sep 25;10(9):e0138978. doi: 10.1371/journal.pone.0138978. eCollection 2015.


Background: Children in low and middle-income countries have a high burden of pneumonia. Measuring the cytokine responses may be useful to identify novel markers for diagnosing, monitoring, and treating pneumonia.

Objective: To describe and compare a wide range of inflammatory mediators in plasma from children with WHO-defined severe and non-severe community acquired pneumonia (CAP), and explore to what extent certain mediators are associated with severity and viral detection.

Methods: We collected blood samples from 430 children with severe (n = 43) and non-severe (n = 387) CAP. Plasma from these children were analysed for 27 different cytokines, and we measured the association with age, disease severity and viral detection.

Results: There were generally higher plasma concentrations of several cytokines with both pro-inflammatory and anti-inflammatory effects among children with severe CAP than in children with non-severe CAP. We found significantly higher concentrations of interleukin (IL)-1, IL-4, IL-6, IL-8, IL-9, IL-15, eotaxin, basic fibroblast growth factor (b-FGF), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor-alpha (TNF-α) in the group of severe CAP. Most of these associations persisted when adjusting for age in linear regression analyses. The cytokine response was strongly associated with age but to a lesser extent with viral etiology.

Conclusion: The plasma concentrations of several cytokines, both with pro-inflammatory and anti-inflammatory effects, were higher among children with severe illness. In particular G-CSF and IL-6 reflected severity and might provide complementary information on the severity of the infection.

Trial registration: NCT00148733.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Community-Acquired Infections / blood*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / epidemiology
  • Female
  • Humans
  • Infant
  • Intercellular Signaling Peptides and Proteins / blood*
  • Interleukins / blood*
  • Male
  • Pneumonia / blood*
  • Pneumonia / diagnosis
  • Pneumonia / epidemiology


  • Intercellular Signaling Peptides and Proteins
  • Interleukins

Associated data


Grants and funding

This work was supported by South-Eastern Norway Regional Health Authority (grant no. 2012090),, TAS; Innlandet Hosptial Trust projectnr: 150263, JH; and European Commission (EU-INCO-DC contract number INCO-FP6-003740), TAS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.