| Cytokine activation patterns and biomarkers are influenced by microorganisms in community-acquired pneumonia. | |
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MedLine Citation:
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PMID: 22194589 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract BACKGROUND:Inflammatory response in community-acquired pneumonia (CAP) depends on the host and on the challenge of the causal microorganism. Here we analyze the patterns of inflammatory cytokines, procalcitonin (PCT) and C-reactive protein (CRP) in order to determine their diagnostic value. METHODS:Prospective study of 658 patients admitted with CAP. PCT and PCR were analyzed by immunoluminometric and immunoturbidimetric assays. Cytokines (TNFα , IL-1β, IL-6, IL-8 and IL-10) were measured using enzyme immunoassay. RESULTS:The lowest medians of CRP, PCT, TNFα and IL-6 were found in CAP of unknown etiology and the highest in patients with positive blood cultures. Different cytokine profiles and biomarkers were found depending on etiology: atypical bacteria (lower PCT and IL-6), viruses (lower PCT and higher IL-10), Enterobacteriaceae (higher IL-8), S. pneumoniae (high PCT) and L. pneumophila (higher CRP and TNFα). PCT ≥0.36 mg/dL to predict positive blood cultures showed sensitivity (S) of 85%, specificity (E) 42% and negative predictive value (NPV) of 98%, whereas a cutoff of ≤0.5 mg/dL to predict viruses/atypical versus bacteria showed S 89/81%, E 68/68%, positive predictive value (PPV) 12/22% and NPV 99/97%. In a multivariate Euclidean distance model, the lowest inflammatory expression was found in unknown etiology and the highest in L. pneumophila, S. pneumoniae and Enterobacteriaceae. Atypical bacteria exhibit an inflammatory pattern closer to that of viruses. CONCLUSIONS:Different inflammatory patterns elicited by microorganisms may provide a useful tool for diagnosis. Recognizing these patterns provides additional information that may facilitate a broader understanding of host inflammatory response to microorganisms. |
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Authors:
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Rosario Menéndez; José Miguel Sahuquillo-Arce; Soledad Reyes; Raquel Martínez; Eva Polverino; Catia Cillóniz; Juan Ginés Córdoba; Beatriz Montull; Antoni Torres |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-22 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Servicio de Neumología, Hospital Universitari i Politècnic La Fe, Valencia, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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