Elderly humans show prolonged in vivo inflammatory activity during pneumococcal infections.

Levels of circulating cytokines were measured in 22 hospitalized patients with pneumococcal infections during the first week after admission, to test for age-associated differences. Twenty-two healthy age- and sex-matched subjects were included as controls. Concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, IL-6, IL-1 receptor antagonist, soluble TNF receptor I (sTNFR-I), and IL-10 were increased on admission (P<.05), but macrophage inflammatory protein (MIP)-1beta was not. Whereas levels of cytokines were similar on admission, levels of TNF-alpha and sTNFR-I after 1 week were higher (P<.05) in elderly (68-91 years) than in young (37-55 years) patients. Furthermore, plasma levels of IL-10 and sTNFR-I after 1 week were positively correlated with age, and the declines in sTNFR-I and in the TNFalpha/IL-10 ratio from day 0 to day 7 were correlated with age. Thus, aging was associated with prolonged inflammatory activity. This may reflect decreased ability to control the infection or a dysregulated cytokine response.