Dynamics of cytokines, immune cell counts and disease severity in patients with community-acquired pneumonia - Unravelling potential causal relationships

Abstract:

BACKGROUND Community acquired pneumonia (CAP) is a severe and often rapidly deteriorating disease. To better understand its dynamics and potential causal relationships, we analyzed time series data of cytokines, blood and clinical parameters in hospitalized CAP patients. METHODS Time series data of 10 circulating cytokines, blood counts and clinical parameters were related to baseline characteristics of 403 CAP patients using univariate mixed models. Bivariate mixed models were applied to analyze correlations between the time series. To identify potential causal relationships, we inferred cross-lagged relationships between pairs of parameters using latent curve models with structured residuals. RESULTS IL-6 levels decreased faster over time in younger patients (Padj = 0.06). IL-8, VCAM-1, and IL-6 correlated strongly with disease severity as assessed by the sequential organ failure assessment (SOFA) score (r = 0.49, 0.48, 0.46, respectively; all Padj \textless 0.001). IL-6 and bilirubin correlated with respect to their mean levels and slopes over time (r = 0.36 and r = 0.46, respectively; Padj \textless 0.001). A number of potential causal relationships were identified, e.g., a negative effect of ICAM-1 on MCP-1, or a positive effect of the level of creatinine on the subsequent VCAM-1 concentration (P \textless 0.001). CONCLUSIONS These results suggest that IL-6 trajectories of CAP patients are associated with age and run parallel to bilirubin levels. The time series analysis also unraveled directed, potentially causal relationships between cytokines, blood parameters and clinical outcomes. This will facilitate the development of mechanistic models of CAP, and with it, improvements in treatment or surveillance strategies for this disease. TRIAL REGISTRATION clinicaltrials.gov NCT02782013, May 25, 2016, retrospectively registered.

PubMed ID: 32896803

DOI: 10.1016/j.cyto.2020.155263

Projects: Genetical Statistics and Systems Biology

Publication type: Journal article

Journal: Cytokine

Human Diseases: No Human Disease specified

Citation: Cytokine 136:155263

Date Published: 1st Dec 2020

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Registered Mode: imported from a bibtex file

Authors: Maciej Rosolowski, Volker Oberle, Peter Ahnert, Petra Creutz, Martin Witzenrath, Michael Kiehntopf, Markus Loeffler, Norbert Suttorp, Markus Scholz

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Rosolowski, M., Oberle, V., Ahnert, P., Creutz, P., Witzenrath, M., Kiehntopf, M., Loeffler, M., Suttorp, N., & Scholz, M. (2020). Dynamics of cytokines, immune cell counts and disease severity in patients with community-acquired pneumonia – Unravelling potential causal relationships. In Cytokine (Vol. 136, p. 155263). Elsevier BV. https://doi.org/10.1016/j.cyto.2020.155263
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Created: 15th Sep 2020 at 08:49

Last updated: 7th Dec 2021 at 17:58

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