The role of new cytokines (interleukin 34, interleukin 35, interleukin 36 alpha, interleukin 37) in the diagnosis of children with acute bronchiolitis and in determining the severity of the disease

Objective: This study was conducted to investigate the possible role of new cytokines (interleukin 34, interleukin 35, interleukin 36 alpha, interleukin 37) in the diagnosis of children with acute bronchiolitis and in determining the severity of the disease. Materials and Methods: This study included 58 patients diagnosed with acute bronchiolitis who came to the Pediatrics outpatient clinic and pediatric emergency department of Harran University Medical Faculty Hospital as the study group, and 30 healthy patients who came to the outpatient clinic for general follow-up (growth and development follow-up, vaccination follow-up, etc.) without bronchiolitis as the control group. IL-34, IL-35, IL-36 alpha, IL-37 parameters were examined using the serum obtained from the patients' blood. SPSS 25.0 statistical package program was used in the analysis phase of the data. Descriptive statistics of the evaluation results were given as number and percentage for categorical variables, and mean and standard deviation for numerical variables. The conformity of the groups to normal distribution was determined by the Kolmogorov-Smirnov test. Comparisons vi of numerical variables between two independent groups; Student T test; ANOVA test was used when the normal distribution condition was provided in comparisons of three or more independent groups, and Pearson correlation test was used in correlation analysis. Statistical alpha significance level was accepted as p<0.05. Results: In this study; 28 (48.3%) of the patient group were female, 30 (51.7%) were male; 11 (36.7%) of the control group were female and 19 (63.3%) were male. According to age ranges; 9 (15.5%) of the patient group were 0-3 months, 29 (50.0%) were 4-12 months, and 20 (34.5%) were 13 months and above; In the control group, 9 (15.5%) were between 0-3 months, 12 (40.0%) were between 4-12 months and 9 (30.0%) were 13 months and over. According to the treatment methods; 18 (31.0%) of the patient group received outpatient treatment, 30 (51.7%) in the ward, 10 (17.2%) in the intensive care unit; in the control group, 9 (30.0%) were outpatient treatment, 13 (43.3%) in the ward and 8 (26.7%) in the intensive care unit. The mean IL-34 (ng/L), IL-35 (ng/L), IL-36 (ng/L) and IL-37 (ng/L) values of the patient group cases were higher than the mean IL-34 (ng/L), IL-35 (ng/L), IL-36 (ng/L) and IL-37 (ng/L) values of the control group cases and the difference between the groups was statistically significant (p:0.000). Although no statistically significant relationship was found between the IL-34 (ng/L), IL-35 (ng/L), IL-36 (ng/L) and IL-37 (ng/L) values of the patient group cases (p>0.05); a positive statistically significant relationship of 60.8% was found between the IL-34 ng/L and IL-35 pg/ml values of the control group cases (r: 0.608; p<0.05). Conclusion: Newly identified interleukins are considered as potential biomarkers in the diagnosis of acute bronchiolitis and determination of disease severity. Especially the anti-inflammatory properties of IL-35 and IL-37 may affect the course of the disease. The pro-inflammatory effects of IL-36α may play a role in the pathogenesis of bronchiolitis. The role of IL-34 requires further investigation. In addition, measuring the serum/plasma levels of these interleukins and examining their correlation with disease severity may contribute to the development of new approaches in the management of bronchiolitis.