Introduction: The leading role in the regulation of the immune response in pneumonia is given to specific mediators of the immune response – cytokines.  The clinical picture and features of pneumonia directly depend on the level of production of anti-inflammatory cytokines and their effect on immunoregulatory and effector immune mechanisms.

Aim: In order to study the role of cytokines in the formation of the inflammatory process in pneumonia, we determined the concentration of anti-inflammatory interleukin4 (IL-4) in the serum of children with community-acquired pneumonia (CAP).

Materials and methods: Determination of interleukin-4 concentration was performed in 45 children with pneumonia aged 6 to 18 years, who were treated in the infectious department of the Children’s Clinical Hospital in Sumy. The comparison group consisted of 19 healthy children. The study was conducted in the acute period of the disease and in the period of stable improvement and discontinuation of antibacterial therapy.  The results of studies obtained in children with CAP were compared with similar indicators of healthy children. Analysis of the data showed that in the acute period of the disease, the level of IL4 was increased 2.5 times in children with moderate to severe disease.  Elevated levels of IL-4 were observed in 77.5% of sick children.  In others, 20.5% of children, the level of IL-4 was significantly lower (143.4%), and in 8.2% of children the level of this cytokine did not differ from normal.  Thus, the level of IL-4 in the serum in the acute period of severe disease was increased 2.8 times, while in moderate severity 2.6 times from that of healthy children.

Results. After treatment, during the convalescence of the disease, the level of IL-4 also decreased, but the rate of its reduction was much lower – only 18%, which is 2.2 times higher than in healthy children. Such more pronounced changes in IL-4 production in children with severe disease during convalescence may indicate that the activity of the inflammatory process, even in the absence of clinical manifestations, continues, especially in children with severe disease that requires further medical supervision.  This allows us to consider the increased level of the above cytokines as one of the criteria for the activity of the inflammatory process.

Сonclusions: The severity of the disorders depends mainly on the severity of the disease and does not depend on the age and sex of the child.  Normalization of the revealed disturbances of interleukin-4 after the carried-out standard treatment does not come. This should be taken into account when developing optimal treatments and rehabilitation measurecommunity-acquired pneumonia in children.