Serum interleukin-6 and mean platelet volume in pediatric pneumonia

Melisa Lilisari; Heda Melinda Nataprawira; Dida Akhmad Gurnida

doi:10.14238/pi56.1.2016.57-61

Melisa Lilisari Department of Child Health, Padjadjaran University Medical School/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
Heda Melinda Nataprawira Department of Child Health, Padjadjaran University Medical School/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
Dida Akhmad Gurnida Department of Child Health, Padjadjaran University Medical School/Dr. Hasan Sadikin Hospital, Bandung, Indonesia

DOI: https://doi.org/10.14238/pi56.1.2016.57-61

Keywords: serum interleukin 6; inflammation; pneumonia

Abstract

Background In pneumonia, interleukin (IL)-6 is released in response to inflammation. Interleukin-6 stimulates megakaryocyte maturation, leading to larger platelets being released into the circulation. Platelet size is measured as mean platelet volume (MPV). The MPV may also be affected by nutritional status and smoking.
Objective To assess for a possible relationship between serum IL-6 concentration and MPV, including smoking and nutritional status as confounding factors, in children with pneumonia.
Methods An analytic, observational study with cross-sectional design and consecutive sampling of children aged 2 to 59 months with a clinical diagnosis of pneumonia was conducted from November 2013 to March 2014 in Dr. Hasan Sadikin General Hospital and two network hospitals. All patients underwent routine complete blood counts including MPV and measurement of serum IL-6 concentration using an enzyme-linked immunosorbent assay (ELISA) technique. Regression linear analysis was used to assess the relationship between MPV and IL-6, passive smoking, and nutritional status.
Results There were 67 patients enrolled in the study. Subjectsâ€™ mean serum IL-6 concentration was 49.3 (SD 78.3) pg/mL, and mean MPV was 9.2 (SD 0.9) fL. The regression model for MPV was 7.531 + 0.662 (passive smoking) + 0.276 (weight per age) + 0.009 (IL-6).
Conclusion There was a relationship between IL-6 serum concentration and MPV in children with pneumonia.

Author Biography

Melisa Lilisari, Department of Child Health, Padjadjaran University Medical School/Dr. Hasan Sadikin Hospital, Bandung, Indonesia

, ,

References

1. WHO/UNICEF. Global action plan for prevention and control of pneumonia (GAPP). World Health Organization/The United Nations Childrenâ€™s Fund. 2009. p. 1-18.
2. Balai Pusat Statistik. Survei demografi dan kesehatan Indonesia 2012. Jakarta: Balai Pusat Statistik; 2012. p. 108-116.
3. Marostica PJ, Stein RT. Community-acquired bacterial pneumonia. In: Wilmott RW, Boat TF, Bush A, Chernick V, Deterding RR, Ratjen F, editors. Disorder of the respiratory tract in children. 8th ed. Philadelphia: Elsevier Saunders; 2012. p. 461-72.
4. Martinez R, Menendez R, Reyes S, Polverino E, Cilloniz C, Martinez A, et al. Factors associated with inflammatory cytokine patterns in community-acquired pneumonia. Eur Respir J. 2011;37:393-9.
5. Endeman H, Meijvis SC, Rijkers GT, van Velzen-Blad H, van Moorsel CH, Grutters J C, et al. Systemic cytokine response in patients with community-acquired pneumonia. Eur Respir J. 2011;37:1431-8.
6. Antunes G, Evans SA, Lordan JL, Frew AJ. Systemic cytokine levels in community-acquired pneumonia and their association with disease severity. Eur Respir J. 2002;20:990-5.
7. Kellum JA, Kong L, Fink MP, Weissfeld LA, Yealy DM, Pinsky MR, et al. Understanding the inflammatory cytokine response in pneumonia and sepsis: results of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Study. Arch Intern Med. 2007;167:1655-63.
8. Michelow IC, Katz K, McCracken GH, Hardy RD. Systemic cytokine profile in children with community-acquired pneumonia. Pediatr Pulmonol. 2007;42:640-5.
9. Burstein SA, Downs T, Friese P, Lynam S, Anderson S, Henthorn J, et al. Thrombocytopoiesis in normal and sublethally irradiated dogs: response to human interleukin-6. Blood. 1992;80:420-8.
10. Giovanetti TV, do Nascimento AJ, de Paula JP. Platelet indices: laboratory and clinical applications. Rev Bras Hematol Hemoter. 2011;33:164-5.
11. Kim KY, Kim KE, Kim KH. Mean platelet volume in the normal state and in various clinical disorders. Yonsei Med J. 1986;27:219-26.
12. Harris M,Clark J,Coote N,Fletcher P, Harnden A. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66:1-23.
13. Klinger MH, Jelkmann W. Role of blood platelets in infection and inflammation. J Interferon Cytokine Res. 2002;22:913-22.
14. Stahl CP, Zucker-Franklin D, Evatt BL, Winton EF. Effects of human interleukin-6 on megakaryocyte development and thrombocytopoiesis in primates. Blood. 1991;78:1467-75.
15. Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C, Wagner OF, et al. Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol. 2011;31:1215-8.
16. Gunluoglu G, Yazar EE, Veske NS, Seyhan EC, Altin S. Mean platelet volume as an inflammation marker in active pulmonary tuberculosis. Multidiscip Respir Med. 2014;9:11.
17. Karadag-Oncel E, Ozsurecki Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumionia in children. Ital J Pediatr. 2013;39:16.
18. Pollard T, Earnshaw W. Cell biology. Philadelphia: Elsevier; 2008. PAGES?
19. Doz E, Noulin N, Boichot E, GuÃ©non I, Fick L, Le Bert M, et al. Cigarette smoke-induced pulmonary inflammation is TLR4/MyD88 and IL-1R1/MyD88 signaling dependent. J Immunol. 2008;180:1169-78.
20. Kopp HP, Kopp CW, Festa A, Kryzanowska K, Kriwanek S, Minar E, et al. Impact of weight loss on inflammatory proteins and their asociation with the insulin resistance syndrome in morbidly obese patient. Arterioscler Thromb Vasc Biol. 2003;23:1042-7.