       Document 0037
 DOCN  M95A0037
 TI    Interleukin-8 and eicosanoid production in the lung during moderate to
       severe Pneumocystis carinii pneumonia in AIDS: a role of interleukin-8
       in the pathogenesis of P. carinii pneumonia.
 DT    9510
 AU    Benfield TL; van Steenwijk R; Nielsen TL; Dichter JR; Lipschik GY;
       Jensen BN; Junge J; Shelhamer JH; Lundgren JD; Department of Infectious
       Diseases, Hvidovre Hospital,; Righospitalet, University of Copenhagen,
       Denmark.
 SO    Respir Med. 1995 Apr;89(4):285-90. Unique Identifier : AIDSLINE
       MED/95320408
 AB    Pneumocystis carinii pneumonia (PCP) may cause severe respiratory
       distress. This is believed to be partly caused by the accumulation of
       neutrophils in the lung. Interleukin-8 (IL-8) and leukotriene B4 (LTB4)
       are potent neutrophil chemo-attractants and activators. Eicosanoids
       [i.e. prostaglandins (PG) and leukotrienes (LT)] are pro-inflammatory
       mediators released from arachidonic acid by action of phospholipase A2
       (PLA2) and have been implicated in the host response to micro-organisms.
       Bronchoalveolar lavage (BAL) was performed on patients with PCP as part
       of a randomized study of adjuvant corticosteroids vs. placebo, in
       addition to standard antimicrobial therapy. Re-bronchoscopy was offered
       at day 10. BAL fluid was available for 26 patients who had follow-up
       bronchoscopy performed. At diagnosis, IL-8 levels were elevated in
       patients with PCP, compared to healthy controls, and correlated with
       relative BAL neutrophilia and P(A-a)O2. LTB4 was also elevated in PCP,
       but failed to correlate with either BAL neutrophilia or P(A-a)O2. PLA2
       activity in patients correlated with IL-8 levels and BAL neutrophilia,
       but not with P(A-a)O2. A trend towards a decrease in IL-8 levels in BAL
       fluid was detected in the corticosteroid-treated patients from days
       0-10, whereas no change was detected in the placebo group. No change in
       levels of LTB4, LTC4, PGE2, PGF2a and PLA2 were detected cover time in
       either treatment group. This study establishes a correlation between
       IL-8, BAL neutrophilia and P(A-a)O2, and suggests a role of IL-8 as a
       mediator in the pathogenesis of PCP, whereas the role of eicosanoids
       seems less clear.
 DE    Adult  AIDS-Related Opportunistic Infections/*METABOLISM
       Bronchoalveolar Lavage Fluid/CHEMISTRY  Eicosanoids/*BIOSYNTHESIS
       Female  Human  Interleukin-8/*BIOSYNTHESIS  Lung/*METABOLISM  Male
       Middle Age  Neutrophils  Phospholipases A/METABOLISM  Pneumonia,
       Pneumocystis carinii/DRUG THERAPY/ETIOLOGY/*METABOLISM
       Prednisolone/THERAPEUTIC USE  Support, Non-U.S. Gov't  CLINICAL TRIAL
       JOURNAL ARTICLE  RANDOMIZED CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

