Cytokine profiles in bronchoalveolar lavage fluid and blood in HIV-seropositive patients with Pneumocystis carinii pneumonia

• Published in: European journal of clinical investigation Vol. 27; no. 4; pp. 333 - 339
• Main Authors: PERENBOOM, R. M., SAUERWEIN, R. W., BECKERS, P., VAN SCHIJNDEL, A. C. H. W., VAN STEENWIJK, R. P., BORLEFFS, J. C. C., VAN LEUSEN, R., VAN DER MEER, J. W. M.
• Format: Journal Article
• Language: English
• Published: Oxford BSL Blackwell Science Ltd 01.04.1997; Blackwell
• Subjects: Adrenal Cortex Hormones - pharmacology; Adult; AIDS-Related Opportunistic Infections - immunology; AIDS/HIV; Biological and medical sciences; Bronchoalveolar Lavage Fluid - chemistry; Cytokine; Cytokines - analysis; Cytokines - biosynthesis; Cytokines - blood; Female; HIV; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; interleukin 1; Interleukin 1 Receptor Antagonist Protein; interleukin 6; interleukin1 receptor antagonist; Male; Medical sciences; Middle Aged; Pneumocystis carinii pneumonia; Pneumonia, Pneumocystis - immunology; Receptors, Tumor Necrosis Factor - analysis; Sialoglycoproteins - analysis; soluble tumour necrosis factor receptor; tumour necrosis factor α; Biological fluid; Pneumonia; Pneumocystis carinii; Soluble form; Blood; Interleukin 6; Bronchoalveolar lavage; Interleukin 1; Antagonist; Biological receptor; Human; Immunopathology; Opportunistic infection; Lung disease; Protozoa; Respiratory disease; Cytokine; Exploration; AIDS; Parasitosis; Immune deficiency; Infection; Tumor necrosis factor; Viral disease; Sporozoa
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1046/j.1365-2362.1997.1170661.x

Concentrations and ex vivo production of interleukin 1β (IL‐1), tumour necrosis α (TNF), interleukin 6 (IL‐6), interleukin‐1 receptor antagonist (IL‐1RA) and TNF soluble receptors (sTNF‐receptors, P55 and P75) were measured in bronchoalveolar lavage (BAL) fluid and blood in 23 HIV‐seropositive (HIV+) patients with Pneumocystis carinii pneumonia (PCP) and compared with values found in healthy HIV‐seronegative (HIV−) controls and asymptomatic HIV+ subjects. Concentrations of the proinflammatory cytokine IL‐1β were increased in BAL fluid of HIV+ patients with PCP (184 ± 47 pg mL−1) compared with undetectable levels in healthy control subjects (P = 0.0001). In plasma of these patients higher concentrations of the anti‐inflammatory cytokine IL‐1RA were found during acute PCP than after recovery (2.1 ± 0.7 vs. 0.5 ± 0.2 ng mL−1, P = 0.01). No correlations could be found between cytokine concentrations and clinical severity of the infection. Corticosteroid treatment did not influence cytokine concentrations in BAL or blood, nor did it suppress the production in alveolar cells. In whole‐blood cultures, however, lipopolysaccharide (LPS)‐stimulated production was significantly suppressed for IL‐1 (1.3 vs. 5.5 ng mL−1, P = 0.009) and for IL‐6 (0.6 vs. 2.5 ng mL−1, P = 0.01). The overall data show that in HIV+ patients with PCP (similar to what we had found previously in HIV− patients with PCP) proinflammatory cytokines are more prominently present in BAL, whereas anti‐inflammatory reaction is predominant in the circulation.