Serum cytokine profile of pediatric patients with laboratory confirmed pneumococcal meningitis

Background: Streptococcus pneumoniae infection is a leading cause of bacterial meningitis in children with severe sequelae. Cytokines are important molecules in regulating of host inflammatory and antiinflammatory responses. So far, the cytokine profile of bacterial meningitis caused by single pathogen has been rarely reported. The aim of this study was to explore serum cytokine profile in pediatric patients with pneumococcal meningitis (PM) and its clinical relevance which could be considered as a valuable tool for differential diagnosis of PM. Methods: During 2015-2018, 95 children with laboratory-confirmed PM were included. Of them, 63 had serum samples at admission. Ten cytokines including TNF-a, IL-12p40, IL-17A, IL-1(3, IFN-eta, GM-CSF, IL-10, CXCL-1, IL-8 and IL-13 were measured by multiplex immunoassay in sera of 63 PM patients and 55 age-matched healthy controls (HCs). Level of serum cytokines was compared with different clinical features of patients. Results: Significantly higher level of IL-10 was observed in patients than HCs (median, 2.19 vs. 1.92 pg/mL, p = 0.017). Significantly lower levels of serum IL-12p40, IL-17A and IL-1 beta were observed in patients than HCs (median, 0.68 vs. 10.12 pg/mL, p < 0.0001; 1.14 vs. 1.14 pg/mL, p = 0.004; 1.00 vs. 5.09 pg/mL, p < 0.0001, respectively). No difference was found in levels of other cytokines between patients and controls. A negative correlation was noticed between percentages of blood neutrophils and concentrations of IL-10 (p = 0.048, r = & minus;0.25). Significantly lower levels of IL-12p40 and CXCL-1 were observed in PM patients with sepsis than those without (median 0.68 vs. 1.64 pg/mL, p = 0.026; 7.25 vs. 12.84 pg/mL, p = 0.043, respectively). Conclusions: Our results suggested that there might be significant changes in serum pro-inflammatory and anti-inflammatory cytokines in PM children and that the determination of these cytokines may have limited value for evaluation of clinical outcome of pediatric PM. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).

Automated summary

The study revealed significant changes in serum pro-inflammatory and anti-inflammatory cytokines in pediatric patients with pneumococcal meningitis. IL-10 levels were significantly higher, while IL-12p40, IL-17A, and IL-1 beta levels were significantly lower in patients compared to healthy controls. Additionally, there was a negative correlation between blood neutrophil percentages and IL-10 concentrations, and lower levels of IL-12p40 and CXCL-1 were observed in patients with sepsis.