The Role Of NF-κB,TNF-α,IL-8 And Celluar Immunity In Children With Community-acquired Pneumonia

Objective To detect levels of NF-κB in blood and BALF in children with community-acquired pneumonia(CAP);to investigate if NF-κB in blood can be one biochemical indicator to evaluate airway inflammation for children with CAP;to study correlation among NF-κB,TNF-α,IL-8 with etiology and pathogenetic condition of children with CAP;to analyse the effect of cellular Immunological function in the pathogenesis of CAP in children.Method 258 cases of children with CAP admitted to the department of respiratory and 29 cases of severe pneumonia admitted to intensive care unit in Children's Hospital Affiliated to Soochow University were colleted,with 30 healthy children as control group.All the patients reveived etiological detection,with their clinical datas colleted and sorted.Blood was taken routinely to detect levels of NF-κB-mRNA with RT-PCR,levels of TNF-α,IL-8 with ELISA,and their T lymphocyte subsets were tested with flow cytometry. BALF specimen of 52 cases were colleted with bronchoscopy for NF-κB-mRNA detection with RT-PCR.Results (1) Compared with control group,levels of NF-κB-mRNA in blood of children in virus group,bacteria group,MP group and combined infection group turned out to be much higher, with obvious statistical variance. For bacteria group,MP group and combined infection group, NF-κB-mRNA was all presented higher than virus group,while no statistical variance was found among previous three groups.(2) Patients with RSV,Pinf-3,HboV,SP,HI infection had higher NF-κB-mRNA levels in blood han healthy children. SP and HI group both had higher NF-κB-mRNA expression levels compared with other three groups respectively, however, no statistical variance was found between previous two groups and posterior three groups on NF-κB-mRNA expression level.(3) Level of NF-κB-mRNA in BALF were higher than that in blood in 52 children who received bronchovideoscope tests, and levels of NF-κB-mRNA in blood and BALF had positive correlation with each other.(4)Levels of NF-κB,TNF-α,IL-8 were all proved as severe pneumonia group﹥non-severe pneumonia group﹥control group.Three factors all have positive correlation with each other.(5) CD3~+,CD3~+CD8~+ lymphocytes were both presented as control group﹥non-severe pneumonia group﹥severe pneumonia group; CD3-CD19~+,CD19~+CD23~+ lymphocytes were proved to be control group﹤non-severe pneumonia group﹤severe pneumonia groups, having statistical variance with each other; while, percentage of CD4~+CD25~+lymphocytes was turned out to be non-severe pneumonia group﹥control group﹥severe pneumonia group. Among three groups, no statistical variance was found both on percentage of CD3~+CD4~+,CD3~+CD(16~+56) ~+ lymphocytes.(6) Respectively, NF-κB,TNF-α,IL-8 had positive correlation with CD3-CD19~+,CD19~+CD23~+ lymphocytes; negtive correlation with CD3~+,CD3~+CD8~+ lymphocytes; no correlation with CD4~+CD25~+,CD3~+CD(16~+56) ~+ and CD3~+CD4~+ lymphocytes.Conculsion (1) NF-κB,TNF-α,IL-8 were involved in the pathogenesis of CAP in children;children with different pathogen infection had different expression levels of NF-κB-mRNA,however, those with same pathogen infection had different pathogenetic conditions as a result of different expression levels of NF-κB-mRNA. (2) Level of NF-κB-mRNA in blood can be one biochemical indicator to evaluate airway inflammation for children with CAP. (3) Children with CAP had disorder of T lymphocyte subsets, and this disorder affects pathogenetic condition at he same time with NF-κB,TNF-αand IL-8.