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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1560328
The role of IL-18 and IL-33 in the bronchoalveolar lavage fluid of children with severe community-acquired pneumonia complicated with pleural effusion
Provisionally accepted- 1Shantou University, Shantou, China
- 2Baoan Central Hospital of Shenzhen, Shenzhen, China
- 3Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
- 4Shenzhen Futian Hospital for Rheumatic Diseases, Shenzhen, China
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AbstractBackground: To investigate the evaluative role of interleukin (IL)-1 family cytokines in bronchoalveolar lavage fluid (BALF) among children with severe community-acquired pneumonia (SCAP) and identify cytokines with clinical relevance for pediatric SCAP.Methods: Children with SCAP hospitalized at Shenzhen Children's Hospital (2019--2020) were studied. IL-1 family cytokines in the BALF were measured via CBA or ELISA. These cytokines included nine IL-1 family members (IL-1α, IL-1β, IL-1Ra, IL-33, IL-18, IL-37, IL-36α, IL-36Ra, and IL-38) and two receptors (sST2 and IL-18BP). The ratio of proinflammatory cytokines to anti-inflammatory cytokines was analyzed.Results: In the BALF of children with SCAP complicated with pleural effusion (PE), the levels of IL-18, the IL-18/IL-38 ratio, and the IL-33 level were significantly elevated (P<0.05). Furthermore, the receiver operating characteristic (ROC) curve indicated that these three markers have strong predictive efficacy for diagnosing SCAP complicated with PE. The levels of members of the IL-1 family, including IL-1α, IL-1β, IL-1Ra, IL-18, and IL-33, and their associated ratios significantly differed across different pathogen groups (P<0.05). IL-36α and the IL-36α/IL-38 ratio differed significantly between the Haemophilus influenzae (Hi)-positive and -negative groups (P<0.0001 and 0.0048), with lower levels in the Hi-positive group.Conclusion: IL-18, IL-33, and IL-38 in BALF may serve as effective markers for predicting the development of PE in pediatric SCAP patients. Additionally, respiratory tract colonization by Hi may diminish the production of specific proinflammatory cytokines, including IL-18, IL-33, and IL-36α, during SCAP.
Keywords: Children, Severe community-acquired pneumonia, IL-1 family, Pleural Effusion, Haemophilus influenzae
Received: 14 Jan 2025; Accepted: 09 Apr 2025.
Copyright: © 2025 Zhang, Liu, Hong, Li, Liang, Lin, Wang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenjian Wang, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
Heping Wang, Shantou University, Shantou, China
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