Serum interleukin-6, interleukin -10, tumor necrosis factor -alpha, neopterin and plasma soluble urokinase plasminogen activator receptor levels in the patients with pandemic H1N1 influenza infection

Objective: This study aims to investigate the clinical importance of serum interleukin (IL) 6, IL-10, tumor necrosis factor alpha (TNF-alpha), neopterin, and plasma soluble urokinase plasminogen activator receptor (suPAR) levels in patients with pandemic H1N1 influenza infection and outpatients diagnosed with upper respiratory infections. Materials and Methods: Twenty-six inpatients with H1N1 infection confirmed by clinical findings and polymerase chain reaction (PCR) test 30 outpatients diagnosed with upper respiratory infections, and 24 healthy individuals without any complaints were included. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were compared between the patients groups and the 24 healthy controls. Serum IL-6, IL-10, TNF-alpha, neopterin levels and plasma suPAR levels were determined through the enzyme-linked immunosorbent assay (ELISA) as per manufacturer’s instructions. Results: The median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 27.8 ng/ml, 9.29 ng/ml, 11.04 ng/ml, 8.82 ng/ml and 5.64 ng/ml, respectively in inpatients with H1N1. In 30 outpatients diagnosed with upper respiratory infections, the median serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 7.24 ng/ml, 1.9 ng/ml, 19.74 ng/ml, 4.37ng/ml and 3.33 ng/ml, respectively. In healthy individuals, the mean IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were 97 ng/ml, 0.16 ng/ml, 4.46 ng/ml, 2.38 ng/ml, 1.65 ng/ml, respectively. In inpatients with H1N1, serum IL-6, IL-10, neopterin levels were significantly higher than those of outpatients diagnosed with upper respiratory infections. In outpatients with upper respiratory infections, serum TNF-alpha levels were higher than in inpatients with H1N1 infection as confirmed by laboratory findings (PCR). In outpatients, serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels were significantly higher from those in the control group. In patients with influenza A (H1N1) infection, serum cytokine levels and plasma suPAR levels were significantly higher from healthy individuals. Conclusion: Serum IL-6, IL-10, TNF-alpha, neopterin, and plasma suPAR levels may be used as clinical follow-up markers in patients with H1N1 infection. J Microbiol Infect Dis 2015;5(3): 119-124