The Role of Serum IL-10 And IL-17 Levels in The Progression and Severity of Bacterial Pneumonia

Abstract

Background: Bacterial pneumonia is still a leading cause of global morbidity and mortality. Interleukin-10(IL-10) and interleukin-17(IL-17), two major cytokines participating in the anti-inflammatory and pro-inflammatory pathways. The objective of the study was to determine whether serum IL-10 and IL-17 acts as a noninvasive marker for bacterial pneumonia staging and severity. Methods: A case-control study was carried out at Al-Sadr Medical City, Al-Najaf, Iraq. This study enrolled 60 patients diagnosed as bacterial pneumonia (cases) and 40 apparently healthy controls. Serum IL-10 and IL-17 using Enzyme-linked immunosorbent assays (ELISA). According to the severity of illness, patients were divided into groups with mild, moderate and severe pneumonia. Results: Serum IL-10 and IL-17 levels in bacterial pneumonia patients were also significantly elevated when compared with healthy controls (P < 0.001). The average IL-10 level was 32.84 ± 8.71 pg/mL in patients vs. 12.63 ± 4.25 pg/mL in controls and the average IL-17 level was 48.57 ± 11.36 pg/mL vs. 18.92 ± 6.14 pg/mL, respectively. Moreover, both cytokines increased significantly with disease severity. Among the three groups, patients with severe pneumonia had the highest concentrations of IL-10 and IL-17 (P = 0.002 and P < 0.001, respectively). Conclusions: High serum IL-10 and IL-17 levels associated with bacterial pneumonia can be used as a significant correlate with severity of disease. Therefore, these results indicate that both cytokines should be helpful for predicting or evaluating the disease severity and disease course of patients with bacterial pneumonia.

Keywords:

IL-10, IL-17, Pneumonia, Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae

References

Al-Fahham, A. A. (2018). Development of new LSD formula when numbers of observations are unequal. Open Journal of Statistics, 8(2), 258–265.

Brito, R. C. C. M., Lucena-Silva, N., Torres, L. C., Luna, C. F., Correia, J. B., & Silva, G. A. P. (2016). The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia. BMC Pulmonary Medicine, 16(1), 170. https://doi.org/10.1186/s12890-016-0324-z

Crowe, C. R., & Chen, K. (2020). Critical role of IL-17 in host immunity during respiratory bacterial infection. Immunology Letters, 225, 15–22. https://doi.org/10.1016/j.imlet.2020.06.004

Feng, C.-M., Wang, X.-M., Li, M.-D., Xu, Z., Hua, D.-X., Cheng, J.-Y., Zheng, L., Zhao, H., & Fu, L. (2021). Serum interleukin-17 predicts severity and prognosis in patients with community-acquired pneumonia: A prospective cohort study. BMC Pulmonary Medicine, 21(1), 393. https://doi.org/10.1186/s12890-021-01770-6

Hadi, H. S., Shubar, S. N. A., Jaffar, A. M., & Alfahham, A. A. (2024). Structure and physiological significance of IL-17: A review article. International Journal of Health & Medical Research, 3(9), 666–669. https://doi.org/10.58806/ijhmr.2024.v3i09n03

Hadi, W. S., Salman, R. S., Al-Fahham, A. A., Khan, M. U. F., Kadir, S., Laft, M. H., … (2022). Evaluation of IL-17 and IL-35 in patients with giardiasis in Thi-Qar province, Iraq. Journal of Medicine and Life, 15(9), 1096–1102.

Kumar, A., Zanotti, S., Bunnell, G., Honavar, J., Zasadzki, M., & Dutta, S. (2009). Interleukin-10 and inflammatory responses in severe bacterial infections. Critical Care Medicine, 37(3), 1034–1041. https://doi.org/10.1097/CCM.0b013e3181968c72

Li, Y., Zhang, X., Wang, H., Liu, J., & Chen, W. (2023). Association of interleukin-17 with severity and prognosis of bacterial pneumonia. BMC Pulmonary Medicine, 23(1), 214. https://doi.org/10.1186/s12890-023-02456-8

Morrison, D. F., Foss, D. L., & Murtaugh, M. P. (2000). Interleukin-10 gene therapy-mediated amelioration of bacterial pneumonia. Infection and Immunity, 68(8), 4752–4758. https://doi.org/10.1128/IAI.68.8.4752-4758.2000

Restrepo, M. I., Schurr, J., Aliberti, S., Anzueto, A., & Faverio, P. (2008). Cytokine responses and clinical outcomes in community-acquired pneumonia. Chest, 133(6), 1342–1348. https://doi.org/10.1378/chest.07-2436

Ritzmann, F., Lunding, L. P., Bals, R., Wegmann, M., & Beisswenger, C. (2022). IL-17 Cytokines and Chronic Lung Diseases. Cells, 11(14), 2132. https://doi.org/10.3390/cells11142132

Sattar, S. B. A., Nguyen, A. D., & Sharma, S. (2026). Bacterial pneumonia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513321

Torres, A., Cilloniz, C., Niederman, M. S., Menéndez, R., Chalmers, J. D., Wunderink, R. G., & van der Poll, T. (2021). Pneumonia. Nature Reviews Disease Primers, 7(1), 25. https://doi.org/10.1038/s41572-021-00259-0

van der Poll, T., & Opal, S. M. (2008). Host-pathogen interactions in sepsis. The Lancet Infectious Diseases, 8(1), 32–43. https://doi.org/10.1016/S1473-3099(07)70265-7

Ye, P., Rodriguez, F. H., Kanaly, S., Stocking, K. L., Schurr, J., Schwarzenberger, P., Oliver, P., Huang, W., Zhang, P., Zhang, J., Shellito, J. E., Bagby, G. J., Nelson, S., Charrier, K., Peschon, J. J., & Kolls, J. K. (2001). Requirement of interleukin 17 receptor signaling for lung CXC chemokine and granulocyte colony-stimulating factor expression, neutrophil recruitment, and host defense. The Journal of Experimental Medicine, 194(4), 519–527. https://doi.org/10.1084/jem.194.4.519