Elevated serum and bronchoalveolar lavage fluid levels of interleukin 8 and granulocyte colony-stimulating factor associated with the acute chest syndrome in patients with sickle cell disease

The role of cytokines in the development of acute chest syndrome (ACS) in p atients with sickle cell disease (SCD) was studied. Serum interleukin 8 (IL -8) levels were elevated in 14 episodes and undetectable in six out of 20 e pisodes of ACS in 19 patients with SCD. In contrast, IL-8 levels were undet ectable in the sera of 29 control patients with SCD studied during routine clinic visits or hospitalization for vaso-occlusive crises. The differences in mean IL-8 levels and the proportion of patients with detectable levels between the two groups were highly significant (P < 0.0001 and 0.04 respect ively). The mean IL-8 level in bronchial fluid samples from children with A CS was also significantly higher than that in sickle cell patients undergoi ng elective surgery (5500 +/- 1400 pg/ml vs. 1900 +/- 470 pg/ml, P = 0.03). Granulocyte colony-stimulating factor (G-CSF) (2000 +/- 1700 pg/ml) was pr esent in five out of six samples of bronchial fluid, but not serum, from ch ildren with ACS. All but one of the patients with ACS studied were negative for the Duffy red cell antigen, which is a receptor that binds and inactiv ates IL-8 and other chemokines. These findings suggest that IL-8 and G-CSF may play a role in the development of the ACS and the complications associa ted with it.