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a Department of
Medicine II, Medizinische Universität Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany, b Institute of Immunology and Transfusion Medicine
Correspondence to: Dr K Dalhoff Klaus.Dalhoff{at}medinf.mu-luebeck.de
Accepted for publication 14 November 2000
BACKGROUND
In the host
defence of the lung neutrophils (PMN) play a central role. Apart from
antimicrobial properties, recent data indicate that PMN also exert
anti-inflammatory effects by stimulation and release of cytokine
antagonists such as interleukin-1 receptor antagonist (IL-1ra).
METHODSCytokine
release from lipopolysaccharide stimulated whole blood was studied
in 18 patients with community acquired pneumonia (CAP) and severe
co-morbidities at admission and after 24 hours. Release of IL-1ra,
interleukin-1
(IL-1), tumour necrosis factor 
(TNF),
soluble TNF receptor type I (sTNF-RI), and IL-8 was determined by ELISA.
RESULTSThe mean (SD)
leucocyte level at admission was 12.5 (4.1)/nl. There was a significant
correlation between the release of anti-inflammatory cytokines such as
IL-1ra and sTNF-RI and the leucocyte count at admission and after 24 hours. Additional in vitro experiments showed that co-incubation of
peripheral blood mononuclear cells with autologous PMN led to a marked
dose dependent increase in IL-1ra and sTNF-RI release.
CONCLUSIONThese
results indicate that PMN may be responsible for the increase in
anti-inflammatory cytokines in CAP. Strategies to increase neutrophil
counts may exert beneficial effects, not only by augmenting the
antimicrobial activity but also by modulating the inflammatory cytokine response.
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