Correlation of Pro- to Anti-Inflammatory Cytokine Ratio with the Clinical Outcomes of Patients with Severe Community-Acquired Pneumonia (CAPISG)

A persistent and deleterious inflammatory response in patients with pneumonia is a consequence of an imbalance of the host production of pro- to anti-inflammatory cytokines. In some patients this imbalance may be due primarily to uncontrolled pro-inflammatory cytokine production and in others due primarily to insufficient anti-inflammatory cytokine response. A “normal” or appropriate ratio of pro- to anti-inflammatory cytokines will be present in pneumonia patients with good clinical outcomes. On the other hand, pneumonia patients who suffer poor clinical outcomes and death will have an “abnormal” or inappropriate high ratio of pro- to anti-inflammatory cytokines.

We are proposing the hypothesis that determination of the blood and alveolar ratio of pro- to anti-inflammatory cytokines at the time of hospitalization can be used as a predictor of mortality in patients with severe pneumonia. We are also proposing that changes of the serum ratio of pro- to anti-inflammatory cytokines during the first seven days of hospitalization can be use to predict the clinical course of hospitalized patients with severe pneumonia. To test these hypotheses, we plan to measure the ratio of pro-inflammatory to anti-inflammatory cytokines in blood and respiratory samples in patients along the course of severe pneumonia.