Moreover, the same factors were compared between the pneumonia patients with and without leukocytosis. Mean peak cytokine and chemokine concentrations in the patients were compared between the two groups using the Mann-Whitney U test. Statistical analysis was performed with StatView software, version J-5.0. No patients required mechanical ventilation and all pneumonia patients recovered completely. Antiviral drugs were administered to 46 patients (oseltamivir; 35 patients, zanamivir; 11 patients), and steroid treatment in addition to antiviral drugs in 21 patients. Steroids were administered soon

after admission SCH772984 nmr to hospital (after serum sample collection). As shown in Table 1, no statistical differences were observed in age, male to female ratio, sampling RXDX-106 datasheet time of the serum, and C-reactive protein concentration between the patients with and without pneumonia. SpO2 was significantly lower in patients with pneumonia than in those without pneumonia (P = 0.036), whereas white blood cell counts were significantly

higher in patients with pneumonia than in those without pneumonia (P = 0.003). Cytokine and chemokine concentrations in patients with and without pneumonia are summarized in Table 1. Expression of IL-10 (23.5 pg/mL vs 9.1 pg/mL, P = 0.027) and IL-5 (18.0 pg/mL vs 12.6 pg/mL, P = 0.014) were significantly higher in patients with pneumonia than in those without pneumonia. No statistical differences between the two groups were observed in the concentrations of the other six cytokines and five chemokines. As shown in Table 2, except for white blood cell counts, no statistical

differences were observed in the other variables assessed, including the detection rate of bacteria in throat swabs from pneumonia patients with and without leukocytosis. As shown in Table 2, neutrophilia contributed exclusively to leukocytosis. Cytokine and chemokine concentrations in these patients are summarized in Table Thiamet G 2. Serum concentrations of IFN-γ (35.7 pg/mL vs 62.8 pg/mL, P = 0.009), TNF-α (9.6 pg/mL vs 18.2 pg/mL, P = 0.01), IL-4 (22.5 pg/mL vs 30.5 pg/mL, P = 0.024), and IL-2 (9.0 pg/mL vs 18.1 pg/mL, P = 0.012) were significantly lower in the pneumonia patients with leukocytosis than in those without leukocytosis. Of the five serum chemokine concentrations assessed, only IL-8 was significantly lower in pneumonia patients with leukocytosis than in those without leukocytosis (16.2 pg/mL vs 181.1 pg/mL, P = 0.001). As reported and discussed in previous studies (3, 4, 8), high concentrations of IL-10, an immunomodulatory cytokine, have been associated with severe cases of pandemic A/H1N1/2009 influenza virus infection and appear to reflect regulation of excessive immune responses due to lung injury in patients with pneumonia. In addition to IL-10, the IL-5 concentration was also significantly higher in patients with pneumonia than in those without pneumonia.