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Cytokines help suggest aplastic anemia with pulmonary bacterial or co-fungal infection

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机构： [1]Department of Hematology, The First People’s Hospital of Yunnan Province, Afliated Hospital of Kunming University of Science and Technology, 157 Jinbi Road, Kunming 650032, China [2]Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China [3]Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China [4]National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China [5]Yunnan Province Clinical Research Center for Hematologic Disease, Kunming, China [6]Emergency Department of Yunnan Provincial Hospital of Traditional Chinese Medicine, Afliated to Yunnan University of Traditional Chinese Medicine, Kunming, China

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Although aplastic anemia (AA) does not come under the category of blood malignant diseases, the infection that frequently occurs in this bone marrow failure can make it worse. Pulmonary infection is the most prevalent but limiting clinical diagnosis. To find biomarkers predicting bacterial or bacterial-combined fungal infections in the lungs, we reviewed 287 AA medical records including 151 without any infection, 87 with pure pulmonary bacterial infection, and 49 with bacterial and fungal infection were reviewed. There were substantial changes in IL-17F, IL-17A, IFN-γ, IL-6, IL-8, and IL-10 levels between the non-infected and lung bacterial infection groups (P < 0.05). Further, a significant variation in IL-17A, TNF-β, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-22, and IL-12p70, between the uninfected group and the pulmonary bacterial and fungal infection group (P < 0.05) was observed. The results further revealed significant differences in TNF-β, IL-12p70, IL-6, IL-8, and IL-10 between the pulmonary bacterial infection group and the fungal infection group (P < 0.05). Moreover, by calculating ROC and cut-off values, we determined that IL-6 (AUC = 0.98, Cut-off = 14.28 pg/ml, P = 0.0000) had a significant advantage than other cytokines, body temperature (AUC = 0.61, P = 0.0050), PCT (AUC = 0.57, P = 0.0592), and CRP (AUC = 0.60, P = 0.0147) in the detection of lungs bacterial infections. In addition, IL-6 (AUC = 1.00, Cut-off = 51.50 pg/ml, P = 0.000) and IL-8 (AUC = 0.87, Cut-off = 60.53 pg/ml, P = 0.0000) showed stronger advantages than other cytokines, body temperature (AUC = 0.60, P = 0.0324), PCT (AUC = 0.72, Cut-off = 0.63 ng/ml, P = 0.0000) and CRP (AUC = 0.79, Cut-off = 5.79 mg/l, P = 0.0000) in distinguishing bacteria from fungi. This may suggest that IL-8 may play a role in differentiating co-infected bacteria and fungi. Such advantages are repeated in severe aplastic anemia (SAA) and very severe aplastic anemia (VSAA).In conclusion, aberrant IL-6 elevations in AA patients may predict the likelihood of bacterial lung infection. The concurrent increase of IL-6 and IL-8, on the other hand, should signal bacterial and fungal infections in patients.These findings may help to suggest bacterial or fungal co-infection in patients with AA (Focus on VSAA and SAA).© 2022. The Author(s).

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出版当年[2022]版：

大类 | 3 区综合性期刊

小类 | 3 区综合性期刊

最新[2023]版：

大类 | 2 区综合性期刊

小类 | 2 区综合性期刊

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出版当年[2021]版：

Q2 MULTIDISCIPLINARY SCIENCES

最新[2023]版：

Q1 MULTIDISCIPLINARY SCIENCES

影响因子： 3.8 最新[2023版] 4.3 最新五年平均 4.997 出版当年[2021版] 5.516 出版当年五年平均 4.38 出版前一年[2020版] 4.6 出版后一年[2022版]

第一作者：

第一作者机构： [1]Department of Hematology, The First People’s Hospital of Yunnan Province, Afliated Hospital of Kunming University of Science and Technology, 157 Jinbi Road, Kunming 650032, China [2]Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China [3]Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China [4]National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China [5]Yunnan Province Clinical Research Center for Hematologic Disease, Kunming, China

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通讯作者：

通讯机构： [1]Department of Hematology, The First People’s Hospital of Yunnan Province, Afliated Hospital of Kunming University of Science and Technology, 157 Jinbi Road, Kunming 650032, China [2]Yunnan Blood Disease Clinical Medical Center, The First People’s Hospital of Yunnan Province, Kunming, China [3]Yunnan Blood Disease Hospital, The First People’s Hospital of Yunnan Province, Kunming, China [4]National Key Clinical Specialty of Hematology, The First People’s Hospital of Yunnan Province, Kunming, China [5]Yunnan Province Clinical Research Center for Hematologic Disease, Kunming, China

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