Reduced levels of interleukin‑1 receptor antagonist act as a marker for pneumonia in the elderly

Zhao,Lijie; Wang,Lina; Zhang,Xiaoyan; Sun,Lili; Sun,Dan; Sun,Tingli

doi:10.3892/mmr.2014.2284

Reduced levels of interleukin‑1 receptor antagonist act as a marker for pneumonia in the elderly

Authors:
- Lijie Zhao
- Lina Wang
- Xiaoyan Zhang
- Lili Sun
- Dan Sun
- Tingli Sun
View Affiliations

Affiliations: Department of Geriatrics, General Hospital of Daqing Oil Field, Daqing, Heilongjiang 163311, P.R. China, Department of Nephrology, General Hospital of Daqing Oil Field, Daqing, Heilongjiang 163311, P.R. China
Published online on: May 29, 2014 https://doi.org/10.3892/mmr.2014.2284
Pages: 959-964

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Pneumonia is a disease causing serious inflammation and infection of the lungs and accounts for >50,000 mortalities annually. The elderly are at an increased risk of developing pneumonia. Pneumonia is more serious in the elderly than in any other age group due to the increased inflammation and risk of community‑acquired pneumonia associated with aging. Interleukin‑1 receptor antagonist (IL‑1RA) is an anti‑inflammatory protein that counteracts the destructive effects of inflammatory proteins. Therefore, the possible association between pneumonia in elderly individuals and reduced levels of IL‑1RA was investigated in the present study. The number of lymphocytes was counted in all subjects and the relative protein expression levels of IL‑1RA were determined using western blot analysis. In addition, the immunological activities of IL‑1RA were measured using ELISA. The results demonstrated that the numbers of lymphocytes in the serum and bronchoalveolar lavage fluid (BALF) were significantly higher in elderly patients than those in young patients. Furthermore, the serum and BALF levels of IL‑1RA in elderly patients were significantly lower than those in young patients (P<0.05 and P<0.01, respectively). Therefore, reduced levels of IL‑1RA in BALF may act as a marker for pneumonia in the elderly and may be a potential adjuvant for the diagnosis of pneumonia in elderly individuals. The results also showed that smoking was associated with significant reductions in the levels of IL‑1RA in the BALF of elderly patients. The association between smokers and non‑smokers found in this study provides support for the hypothesis that smoking may contribute to the pathogenesis of pneumonia by further reducing IL‑IRA levels in certain elderly patients.

View Figures

View References

1	Wilson BZ, Anzueto A, Restrepo MI, Pugh MJ and Mortensen EM: Comparison of two guideline-concordant antimicrobial combinations in elderly patients hospitalized with severe community-acquired pneumonia. Crit Care Med. 40:2310–2314. 2012. View Article : Google Scholar
2	Cabre M: Pneumonia in the elderly. Curr Opin Pulm Med. 15:223–229. 2009. View Article : Google Scholar : PubMed/NCBI
3	Esayag Y, Nikitin I, Bar-Ziv J, et al: Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia. Am J Med. 123:88.e1–88.e5. 2010. View Article : Google Scholar : PubMed/NCBI
4	Murdoch DR: Nucleic acid amplification tests for the diagnosis of pneumonia. Clin Infect Dis. 36:1162–1170. 2003. View Article : Google Scholar : PubMed/NCBI
5	Christ-Crain M and Opal SM: Clinical review: the role of biomarkers in the diagnosis and management of community-acquired pneumonia. Crit Care. 14:2032010. View Article : Google Scholar : PubMed/NCBI
6	Hinojosa E, Boyd AR and Orihuela CJ: Age-associated inflammation and toll-like receptor dysfunction prime the lungs for pneumococcal pneumonia. J Infect Dis. 200:546–554. 2009. View Article : Google Scholar : PubMed/NCBI
7	Berezin V and Bock E: Antagonists of the interleukin-1 receptor. WO Patent App. PCT/DK2012/000,022. Filed March 14, 2012; issued September 20, 2012.
8	Mani D, Guinee DG Jr and Aboulafia DM: Vanishing lung syndrome and HIV infection: an uncommon yet potentially fatal sequela of cigarette smoking. J Int Assoc Physicians AIDS Care (Chic). 11:230–233. 2012. View Article : Google Scholar : PubMed/NCBI
9	Clifford GM, Lise M, Franceschi S, et al: Swiss HIV Cohort Study: Lung cancer in the Swiss HIV Cohort Study: role of smoking, immunodeficiency and pulmonary infection. Br J Cancer. 106:447–452. 2012. View Article : Google Scholar : PubMed/NCBI
10	Kikuchi R, Watabe N, Konno T, Mishina N, Sekizawa K and Sasaki H: High incidence of silent aspiration in elderly patients with community-acquired pneumonia. Am J Respir Crit Care Med. 150:251–253. 1994. View Article : Google Scholar : PubMed/NCBI
11	Okamoto M, Hoshino T, Kitasato Y, et al: Periostin, a matrix protein, is a novel biomarker for idiopathic interstitial pneumonias. Eur Respir J. 37:1119–1127. 2011. View Article : Google Scholar : PubMed/NCBI
12	Dolinay T, Kim YS, Howrylak J, et al: Inflammasome-regulated cytokines are critical mediators of acute lung injury. Am J Respir Crit Care Med. 185:1225–1234. 2012. View Article : Google Scholar : PubMed/NCBI
13	Sisson TH, Mendez M, Choi K, et al: Targeted injury of type II alveolar epithelial cells induces pulmonary fibrosis. Am J Respir Crit Care Med. 181:254–263. 2010. View Article : Google Scholar : PubMed/NCBI
14	Grommes J and Soehnlein O: Contribution of neutrophils to acute lung injury. Mol Med. 17:293–307. 2011. View Article : Google Scholar : PubMed/NCBI
15	Cecere LM, Williams EC, Sun H, et al: Smoking cessation and the risk of hospitalization for pneumonia. Respir Med. 106:1055–1062. 2012. View Article : Google Scholar : PubMed/NCBI
16	Katzenstein AL: Smoking-related interstitial fibrosis (SRIF), pathogenesis and treatment of usual interstitial pneumonia (UIP), and transbronchial biopsy in UIP. Mod Pathol. 25(Suppl 1): S68–S78. 2012. View Article : Google Scholar
17	Jeong YJ, Lee KS, Chung MP, Han J, Johkoh T and Ichikado K: Chronic hypersensitivity pneumonitis and pulmonary sarcoidosis: differentiation from usual interstitial pneumonia using high-resolution computed tomography. Semin Ultrasound CT MR. 35:47–58. 2014. View Article : Google Scholar
18	Lynch DA and Huckleberry JM: Usual interstitial pneumonia: typical and atypical high-resolution computed tomography features. Semin Ultrasound CT MR. 35:12–23. 2014. View Article : Google Scholar : PubMed/NCBI
19	Eisman Hidalgo M, Nuñez-Delgado Y and García Espona MÁ: Idiopathic lipoid pneumonia findings in chest high resolution computed tomography. A case report. Arch Bronconeumol. 50:83–84. 2014.(In English and Spanish).
20	Hsu MJ, Lu YC, Hsu YC, Liu WS and Wu WT: Interleukin-1 receptor antagonist gene polymorphism in patients with multidrug-resistant Acinetobacter baumannii-associated pneumonia. Ann Thorac Med. 7:74–77. 2012. View Article : Google Scholar : PubMed/NCBI
21	Patwari PP, O‘Cain P, Goodman DM, et al: Interleukin-1 receptor antagonist intron 2 variable number of tandem repeats polymorphism and respiratory failure in children with community-acquired pneumonia. Pediatr Crit Care Med. 9:553–559. 2008. View Article : Google Scholar
22	Miki C, Inoue Y, Toiyama Y, et al: Deficiency in systemic interleukin-1 receptor antagonist production as an operative risk factor in malnourished elderly patients with colorectal carcinoma. Crit Care Med. 33:177–180. 2005. View Article : Google Scholar : PubMed/NCBI
23	Boström L, Linder LE and Bergström J: Smoking and GCF levels of IL-1beta and IL-1ra in periodontal disease. J Clin Periodontol. 27:250–255. 2000.PubMed/NCBI