Document Detail


Systemic Inflammatory Pattern of Community-Acquired Pneumonia (CAP) Patients With and Without Chronic Obstructive Pulmonary Disease (COPD).
MedLine Citation:
PMID:  23187314     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT BACKGROUND Several clinical studies have evaluated the role of chronic obstructive pulmonary disease (COPD) in community-acquired pneumonia (CAP) patients. We investigated the systemic inflammatory response of CAP patients with (CAP+COPD) and patients without associated COPD (CAP only). METHODS Clinical, microbiological and immunological data were collected from 367 prospective patients on admission to hospital during a 3-year period. Comparative analyses were performed between CAP+COPD (n=117) and CAP only patients (n=250) and between patients with and without domiciliary use of inhaled (ICS) and oral corticosteroids. RESULTS Detailed characteristics of clinical severity and prognosis (mortality on hospitalization, at 30 days and at 90 days) were similar between CAP+COPD and CAP only patients. The re-admission rate and the frequency of a previous pneumonia were higher in the group of CAP+COPD patients.On day 1 (admission to hospital) CAP+COPD patients had significantly lower serum levels of tumour necrosis factor (TNF) α, interleukin (IL) 1 and IL-6 compared with CAP only patients; the remaining inflammatory biomarkers (C-reactive protein, procalcitonin, IL-8 and IL-10) were similar at days 1 and 3. The exclusion of patients with domiciliary use of ICS and oral corticosteroids confirms lower levels of TNF-α on day 1 in CAP+COPD patients. Finally, lower levels of IL-6 were found only among those COPD patients who were currently using ICS. CONCLUSION Our prospective study demonstrates a different, disease-specific early inflammatory pattern between CAP patients with and without associated COPD; these finding are not completely corticosteroid-mediated.1Department of Pulmonary Rehabilitation, Ospedale Villa Pineta - University of Modena and Reggio Emilia, Modena, Italy. ecrisafulli@pneumonet.it, enrico.clini@unimore.it2Servicio de Neumología, Hospital Universitario y politecnico La Fe, CIBERES, Valencia, Spain, rosmenend@gmail.com, rasmartinez@hotmail.com, gelina82@comv.es3Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - University of Barcelona (UB) - Supported by: 2009 SGR 911, Ciber de Enfermedades Respiratorias (Ciberes CB06/06/0028), Pneumonia Corporate Research Program (CRP). The Ciberes is an initiative of the ISCIII. SGR: Support to research groups of Catalunya - Barcelona, Spain. ahuerta@clinic.ub.es, ATORRES@clinic.ub.esCORRESPONDENCE: Prof. Antoni Torres - Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic, Villarroel 170. 08036 Barcelona, Spain. E-mail: ATORRES@clinic.ub.esFunding/Support: This manuscript was supported by a grant from Marato TV3 - Spain.
Authors:
Ernesto Crisafulli; Rosario Menéndez; Arturo Huerta; Raquel Martinez; Beatriz Montull; Enrico Clini; Antoni Torres
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-24
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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