Prognostic and Clinical Significance of Peripheral Blood IL-2, IL-8, and TNF-α in Children with Severe Pneumonia.

Authors

Jiachen Xu, Huihui Liu, Shuyang Zheng, Yadan Li, Shuyue Zhao

Published in

International journal of general medicine. Volume 19. Pages 608784. Epub Jul 14, 2026.

Abstract

Severe pediatric pneumonia remains a major clinical burden and early prediction of deterioration is essential for timely risk stratification. This retrospective study evaluated baseline peripheral blood interleukin-2 (IL-2), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and the modified PIRO (mPIRO) score for predicting progression to severe pneumonia in hospitalized children.
We analyzed 143 children with initially non-severe community-acquired pneumonia admitted between October 2020 and February 2022, together with 60 age-matched healthy controls. During hospitalization, 121 children maintained an uncomplicated course and 22 progressed to severe pneumonia. Serum IL-2, IL-8, and TNF-α levels were measured within 24 h of admission using residual serum from routine clinical testing. Logistic regression, ROC analysis, and a nomogram were used to assess predictors and internal cohort discriminative efficacy.
Children with pneumonia had significantly higher IL-2, IL-8, and TNF-α levels than healthy controls (all P < 0.001). Among children with pneumonia, those who progressed to severe disease had higher baseline IL-2 (85.7 ± 14.9 vs 63.0 ± 26.2 pg/mL), TNF-α (91.9 ± 12.5 vs 76.6 ± 9.88 pg/mL), and mPIRO scores (6.0 [5.0-6.0] vs 5.0 [4.0-5.0]; all P < 0.001), whereas IL-8 did not differ significantly (P = 0.622). IL-2, TNF-α, and mPIRO remained independent predictors in multivariable analysis. The combined model showed the highest apparent AUC (0.935, 95% CI 0.877-0.993), compared with mPIRO alone (0.858), TNF-α (0.826), and IL-2 (0.778).
Baseline IL-2, TNF-α, and mPIRO were associated with subsequent progression to severe pneumonia in children. The combined cytokine-mPIRO model may provide preliminary incremental prognostic information, but prospective multicenter validation and comparison with established biomarkers are required before routine clinical implementation.

PMID:
42472026
Bibliographic data and abstract were imported from PubMed on 19 Jul 2026.

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