Early proinflammatory cytokines and C-reactive protein trends as predictors of outcome in invasive Aspergillosis.
Fiche publication
Date publication
novembre 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HERBRECHT Raoul
Tous les auteurs :
Chai LA, Netea MG, Teerenstra S, Earnest A, Vonk AG, Schlamm HT, Herbrecht R, Troke PF, Kullberg BJ
Lien Pubmed
Résumé
BACKGROUND: Monitoring treatment response in invasive aspergillosis is challenging, because an immunocompromised host may not exhibit reliable symptoms and clinical signs. Cytokines play a pivotal role in mediating host immune response to infection; therefore, the profiling of biomarkers may be an appropriate surrogate for disease status. METHODS: We studied, in a cohort of 119 patients with invasive aspergillosis who were recruited in a multicenter clinical trial, serum interleukin (IL)-6, IL-8, IL-10, interferon-gamma, and C-reactive protein (CRP) trends over the first 4 weeks of therapy and correlated these trends to clinical outcome parameters. RESULTS: Circulating IL-6 and CRP levels were high at initiation of therapy and generally showed a downward trend with antifungal treatment. However, subjects with adverse outcomes exhibited a distinct lack of decline in IL-6 and CRP levels at week 1, compared with responders (P = .02, for both IL-6 and CRP). Nonresponders also had significantly elevated IL-8 levels (P = .001). CONCLUSIONS: High initial IL-8 and persistently elevated IL-6, IL-8, and CRP levels after initiation of treatment may be early predictors of adverse outcome in invasive aspergillosis. Cytokine and CRP profiles could be used for early identification of patients with a poor response to antifungal treatment who may benefit from more-aggressive antimicrobial regimens.
Référence
J Infect Dis. 2010 Nov 1;202(9):1454-62.