Analysis of T cell cytokines and inflammatory blood cell indices in children with inflammatory bowel disease com-plicated by clostridium difficile infection:their expression and prognostic value
ZHANG Gui-zhen
SONG Yun-jing
GAO Kai-jie
YANG Jun-mei
GAO Jian
XU Lu
ZHOU Ying
ZHEN Ming-hui
FANG Pan-pan
ZHOU Juan-juan
ZHANG Dong-yu
Abstract：Objective To explore the expression levels of T cell cytokines and inflammatory blood cell indices in children with inflammatory bowel disease(IBD)complicated by Clostridium difficile infection(CDI)and their prognostic assessment value.Methods This study included 118 children with CDI and IBD treated at our hospital from September 2021 to January 2024.Based on clinical responses,patients were divided into a good prognosis group(n=87)and a poor prognosis group(n=31).Pre-treatment clinical data,levels of T cell cytokines[interleukin(IL)-6,IL-8,IL-10,IL-17,tumor necrosis factor-α(TNF-α)],and inflammatory blood cell indices[neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),(lymphocyte-to-monoeyte ratio(LMR),systemic immune-in-flammation ondex(SII)]were collected and compared between the groups.Spearman correlation and multivariate logistic regression analyses identified risk factors for poor prognosis,and ROC curves evaluated the predictive value of these fac-tors.Results The proportion of children using probiotics in the poor prognosis group was significantly lower than that in the good prognosis group(P＜0.05).The average levels of IL-6 and TNF-α were significantly higher,while IL-10 and IL-17 were significantly lower in the poor prognosis group(P＜0.05).NLR,PLR,and SII were significantly high-er,and LMR was significantly lower in the poor prognosis group(P＜0.05).Spearman correlation showed significant pos-itive correlations between IL-6,TNF-α,NLR,PLR,SII and poor prognosis(r=0.420,0.334,0.666,0.466,0.688,P＜0.001),while probiotics,IL-10,IL-17,and LMR were negatively correlated(r=-0.206,-0.345,-0.416,-0.470,P＜0.001).Multivariate logistic regression indicated that high levels ofIL-6,TNF-α,NLR,SII and low levels of IL-10,IL-17 were significant risk factors for poor prognosis,with high predictive efficiency(AUC=0.776,0.727,0.773,0.719,0.841,0.895,0.957).Conclusion Elevated pro-inflammatory T cell cyto-kines and inflammatory blood cell indices,along with reduced anti-inflammatory T cell cytokines,are closely associated with poor prognosis in children with CDI and IBD.Monitoring the baseline inflammatory status and changes in inflammato-ry indices is crucial for accurately predicting outcomes in these patients.
Keywords：Clostridium difficile infectioninflammatory bowel diseaseT cytokineblood cell inflammation in-dexprognosis
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1312-1318 )