Trial reportClinical and vaccine immunology : CVI2012
Dexamethasone downregulates the systemic cytokine response in patients with community-acquired pneumonia.
Trial report in Clinical and vaccine immunology : CVI, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Efficacy and safety of glucocorticoids therapy of severe community-acquired pneumonia in older adults: a systematic review and meta-analysis.BMC geriatrics · 2025Pooled it
- Trial
- In vitro evaluation of anti-inflammatory drugs Ibuprofen and Dexamethasone against Acinetobacter baumannii.BMC microbiology · 2026Article
- The heterogeneous treatment effect of adjuvant therapy with corticosteroids in patients with Community-Acquired Pneumonia: a review.Pneumonia (Nathan Qld.) · 2026Review
- Comparative renoprotective effects of phoenixin-14, a novel peptide, and dexamethasone in LPS-induced sepsis: targeting inflammation, oxidative stress, and apoptosis.Apoptosis : an international journal on programmed cell death · 2026Article
- Corticosteroid and antimicrobial therapy in macrolide-resistant pneumococcal pneumonia porcine model.Intensive care medicine experimental · 2025Article
- Postoperative neurocognitive disorders in the elderly: how can we stop the harm? A literature review.Frontiers in medicine · 2025Review
- Corticosteroids in bacterial severe community-acquired pneumonia: lessons from recent trials.Frontiers in medicine · 2025Article
- Article
- Latent class analysis-based subgroups and response to corticosteroids in hospitalised community-acquired pneumonia patients: a validation study.ERJ open research · 2023Article
- Clinical analysis of the epidemiology and changes in inflammatory indexes ofTranslational pediatrics · 2022Article
- Association between dexamethasone treatment and the host response in COVID-19 patients admitted to the general ward.Respiratory research · 2022Article
- SARS-CoV-2 infection results in immune responses in the respiratory tract and peripheral blood that suggest mechanisms of disease severity.Nature communications · 2022Article
- Immune responses in COVID-19 respiratory tract and blood reveal mechanisms of disease severity.Research square · 2021Article
- Clinical characteristics of refractory mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy.BMC infectious diseases · 2021Article
- Preventing the development of severe COVID-19 by modifying immunothrombosis.Life sciences · 2021Review
- Tumour-associated macrophage-derived interleukin-1 mediates glioblastoma-associated cerebral oedema.Brain : a journal of neurology · 2019Article
- Adjunctive corticosteroid therapy for inpatients with Mycoplasma pneumoniae pneumonia.BMC pulmonary medicine · 2017Article
- Rare presentation of an old bug.BMJ case reports · 2017Article
- Host-Directed Therapeutic Strategies for Tuberculosis.Frontiers in medicine · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The influence of adjunctive corticosteroids on the cytokine response in community-acquired pneumonia (CAP) is largely unknown. In this study, we analyzed the effect of dexamethasone on the cytokine response in patients with CAP and evaluated whether this effect is dependent on the causative microorganism. We hypothesized that dexamethasone has a larger effect on the cytokine response in patients with pneumococcal pneumonia than in patients with pneumonia caused by an atypical bacterium. A total of 304 hospitalized, nonimmunocompromised patients with CAP were randomized to an adjunctive 4-day course of 5 mg dexamethasone once a day (n = 151) or a placebo (n = 153). Serum concentrations of interleukin-1 receptor antagonist (IL-1Ra), IL-6, IL-8, IL-10, IL-17, tumor necrosis factor alpha (TNF-α), gamma interferon (IFN-γ), macrophage inflammatory protein-1 alpha (MIP-1α), and monocyte chemotactic protein-1 (MCP-1) were measured on days 0, 1, 2, and 4 and at a control visit. Overall, the concentrations of IL-6 (P < 0.01), IL-8 (P < 0.01), MCP-1 (P < 0.01), and TNF-α (P < 0.01) were significantly lower on day 2 in the dexamethasone group than in the placebo group. In patients with pneumococcal pneumonia (n = 72), both treatment groups showed a rapid decrease of cytokine concentrations; only the concentration of TNF-α (P = 0.05) was significantly lower in the dexamethasone group on day 2. In patients with CAP caused by an atypical pathogen (Legionella pneumophila, Chlamydophila species, Coxiella burnetii, or Mycoplasma pneumoniae; n = 58), IL-1Ra (P < 0.01), IL-6 (P < 0.01), and MCP-1 (P = 0.03) decreased more rapidly in the dexamethasone group than in the placebo group. In conclusion, dexamethasone downregulates the cytokine response during CAP. This effect seems to be dependent on the causative microorganism. This study provides insight into which patients with CAP might benefit most from adjunctive dexamethasone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.