Introduction: Pneumonia in children of all age groups has a strong association with morbidity. This highlights the importance of studying the clinical and diagnostic aspects of community-acquired pneumonia. For those suffering from pneumonia, general biological patterns, in some cases, outstrip morphological changes in tissues and therefore biological changes can be considered as early signs of the development of the disease. Through this research, we looked at the possibility of using proinflammatory cytokines in the urine, by a non-invasive method, to assess the prognosis of
community-acquired pneumonia in children.
Objective: To study the possibility of using IL-6 content in biological fluids in order to predict the severity of community-acquired pneumonia in children.
Methods: In a prospective cohort study, 110 children with community-acquired pneumonia aged between 5-10 years (who were undergoing treatment in the respiratory department of the Children’s Hospital of Karaganda, Kazakhstan) were monitored. 43.64% were girls (CI 95% 31.51% –56 , 33%) and 56.36% boys (CI 95% 34.91% – 59.88%). Statistical processing of the research results was carried out with the determination of the mean value (M) and the standard error of the mean (m). A comparison of the series was carried out in cases of an abnormal distribution, by means of the nonparametric Mann-Whitney criterion. Differences were considered significant at p <0.05.
Results: Elevated levels of IL-6 in serum were observed in all patient groups. In patients with grade II, the level of this marker was 2.5 times higher than in the control group (p <0.03). At grade III of bacterial pneumonia, the level of IL-6 was 6.89 ± 0.53 pg / ml, 8-fold higher than in the control group (p <0.03), 6-times higher compared with grade I (p <0 , 00) and 3 times higher compared with the IInd degree (p <0.00). When studying the level of IL-6 in urine, its increase is revealed as the severity of the disease worsens. In patients with grade II, the level of this marker was 3.5 times higher in comparison with the control group (p <0.002) and 2 times compared with the Ist degree (p <0.015). At grade III of bacterial pneumonia, the level of IL-6 was 5.21 ± 0.40 pg / ml, 5 times higher compared to the control group (p <0.002), 3.5 times compared with grade I (p <0.002 ) and 1.5 times in comparison with IInd degree (p <0.04).
Conclusions: The results of our study indicate that as the severity of pneumonia increases, the titer of IL-6 in serum and urine in children with community-acquired pneumonia increases. During the study, based on the data obtained, as the severity of community-acquired pneumonia increased, titers of proinflammatory cytokines increased both in blood serum and in urine in sick children. This raises the possibility of using IL-6 as a non-invasive test for predicting the severity of community-acquired pneumonia in children.
Key words: pneumonia, children, diagnosis, IL-6