Peculiarities of peroxide homeostasis and cytokine status in children with community-acquired pneumonia of various etiologies

Respiratory diseases in children occupy a leading position in the structure of childhood morbidity and are the focus of attention of pediatricians both due to their high prevalence and the high risk of developing complicated and chronic forms. An urgent task of modern pediatrics is to study not only the etiology, but also the pathogenetic mechanisms of the development of lower respiratory tract lesions due to the difficulties in diagnosis and the high risk of developing life-threatening conditions. Due to the special role of Streptococcus pneumoniae among pneumotropic pathogens, it was of interest to search for characteristic etiopathogenetic features of the development of pneumonias caused by this pathogen.

Purpose. To study the activity of lipoperoxidation indicators, as well as the course of pro- and anti-inflammatory reactions by the level of cytokines in the peripheral blood in children with community-acquired pneumonia of various etiologies.

Material and methods. The study included 129 children (58 boys and 71 girls) aged 5 to 17 years with various morphological variants of community-acquired pneumonia, who were divided into groups based on the etiology of the pathogen. All children had their levels of TNF-α, IL-1, IL-4, and IL-8 interleukins determined using ELISA, as well as their levels of malondialdehyde, antioxidant activity, and ceruloplasmin in their blood serum.

Results. It was shown that 24.8% of the examined children had Streptococcus pneumoniae-induced pneumonia, with 84.3% of them showing clinically significant intoxication and respiratory disorders, and 65.6% showing a decrease in O2 saturation to 91–93%. This group also showed the highest values of pro-inflammatory cytokines, malondialdehyde, and the lowest values of total antioxidant activity and ceruloplasmin. The more subtle clinical symptoms of other types of viral pneumonia were accompanied by parallel increases in pro- and anti-inflammatory cytokines and less significant disturbances in peroxide homeostasis.

Conclusions. Outpatient pneumococcal pneumonia is usually characterized by severe clinical course, high pro-inflammatory cytokine activity, and impaired peroxide homeostasis.

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