1
|
Fan Y, Ye Z, Tang Y. Serum HMGB1 and soluble urokinase plasminogen activator receptor levels aid diagnosis and prognosis prediction of sepsis with acute respiratory distress syndrome. Biomark Med 2023; 17:231-239. [PMID: 37158106 DOI: 10.2217/bmm-2022-0899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Objective: To study the clinical application of serum HMGB1 and soluble urokinase plasminogen activator receptor (suPAR) expression in sepsis with acute respiratory distress syndrome (ARDS). Methods: Clinical data of 303 septic patients with/without ARDS were documented. Levels of serum inflammatory markers and HMGB1/suPAR were measured. ARDS patients were subdivided into high and low HMGB1/suPAR expression groups and followed up. Results: Serum HMGB1 and suPAR were upregulated in ARDS patients and positively correlated with inflammatory markers. The combination of HMGB1 with suPAR surpassed HMGB1 or suPAR alone in aiding diagnosis of sepsis with ARDS. CRP, PCT, IL-6, HMGB1 and suPAR were independent risk factors for ARDS. High HMGB1/suPAR expression might be linked to poor prognosis. Conclusion: Serum HMGB1/suPAR levels might aid diagnosis and predict poor prognosis of septic patients with ARDS.
Collapse
Affiliation(s)
- Yuanhua Fan
- Department of Emergency, Qingpu Branch of Zhongshan Hospital of Fudan University, Shanghai, 201700, China
| | - Zhimei Ye
- Department of Emergency, Qingpu Branch of Zhongshan Hospital of Fudan University, Shanghai, 201700, China
| | - Yan Tang
- Department of Emergency, Qingpu Branch of Zhongshan Hospital of Fudan University, Shanghai, 201700, China
| |
Collapse
|
2
|
Liu Z, Liu D, Wang Z, Zou Y, Wang H, Li X, Zheng D, Zhou G. Association between inflammatory biomarkers and acute respiratory distress syndrome or acute lung injury risk : A systematic review and meta-analysis. Wien Klin Wochenschr 2021; 134:24-38. [PMID: 34860273 PMCID: PMC8813738 DOI: 10.1007/s00508-021-01971-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/16/2021] [Indexed: 11/29/2022]
Abstract
Background The relationship between acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and levels of certain inflammatory factors remains controversial. The purpose of this meta-analysis was to summarize the available studies evaluating the association between levels of inflammatory factors and ARDS/ALI incidence. Methods We searched the PubMed, EmBase, and Cochrane databases for studies published up to July 2017. For each inflammatory factor, a random effects model was employed to pool results from different studies. Results We identified 63 studies that included 6243 patients in our meta-analysis. Overall, the results indicated that the levels of angiopoietin (ANG)-2 (standard mean difference, SMD: 1.34; P < 0.001), interleukin (IL)-1β (SMD: 0.92; P = 0.012), IL‑6 (SMD: 0.66; P = 0.005), and tumor necrosis factor (TNF)-α (SMD: 0.98; P = 0.001) were significantly higher in patients with ARDS/ALI than in unaffected individuals. No significant differences were observed between patients with ARDS/ALI and unaffected individuals in terms of the levels of IL‑8 (SMD: 0.61; P = 0.159), IL-10 (SMD: 1.10; P = 0.231), and plasminogen activator inhibitor (PAI)-1 (SMD: 0.70; P = 0.060). Conclusions ARDS/ALI is associated with a significantly elevated levels of ANG‑2, IL-1β, IL‑6, and TNF‑α, but not with IL‑8, IL-10, and PAI‑1 levels. Supplementary Information The online version of this article (10.1007/s00508-021-01971-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Zhenfeng Liu
- Department of Respiratory Medicine, Zunyi Honghuagang District People's Hospital, 185 Wanli Road, HongHuagang District, 563000, Guizhou, China.,Department of Respiratory Medicine, the Third Affiliated Hospital of Zunyi Medical University, 98 Fenghuang Road, Huichuan District, 563000, Guizhou, China
| | - Daishun Liu
- Department of Respiratory Medicine, the Third Affiliated Hospital of Zunyi Medical University, 98 Fenghuang Road, Huichuan District, 563000, Guizhou, China
| | - Zhihua Wang
- Department of Respiratory Medicine, Teaching Hospital of Zunyi Medical College, 134 LinJiapo Road, HongHuagang District, 563000, Guizhou, China
| | - Yugang Zou
- Department of Respiratory Medicine, the Third Affiliated Hospital of Zunyi Medical University, 98 Fenghuang Road, Huichuan District, 563000, Guizhou, China
| | - Haixia Wang
- Department of Respiratory Medicine, Suzhou Science & Technology Town Hospital, 215153, Jiangsu, China
| | - Xiao Li
- Department of Respiratory Medicine, Teaching Hospital of Zunyi Medical College, 134 LinJiapo Road, HongHuagang District, 563000, Guizhou, China
| | - Deliang Zheng
- Department of Respiratory Medicine, Teaching Hospital of Zunyi Medical College, 134 LinJiapo Road, HongHuagang District, 563000, Guizhou, China
| | - Guoqi Zhou
- Department of Respiratory Medicine, Teaching Hospital of Zunyi Medical College, 134 LinJiapo Road, HongHuagang District, 563000, Guizhou, China.
| |
Collapse
|
3
|
Bonnesen B, Jensen JUS, Jeschke KN, Mathioudakis AG, Corlateanu A, Hansen EF, Weinreich UM, Hilberg O, Sivapalan P. Management of COVID-19-Associated Acute Respiratory Failure with Alternatives to Invasive Mechanical Ventilation: High-Flow Oxygen, Continuous Positive Airway Pressure, and Noninvasive Ventilation. Diagnostics (Basel) 2021. [DOI: doi.org/10.3390/diagnostics11122259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Patients admitted to hospital with coronavirus disease 2019 (COVID-19) may develop acute respiratory failure (ARF) with compromised gas exchange. These patients require oxygen and possibly ventilatory support, which can be delivered via different devices. Initially, oxygen therapy will often be administered through a conventional binasal oxygen catheter or air-entrainment mask. However, when higher rates of oxygen flow are needed, patients are often stepped up to high-flow nasal cannula oxygen therapy (HFNC), continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), or invasive mechanical ventilation (IMV). BiPAP, CPAP, and HFNC may be beneficial alternatives to IMV for COVID-19-associated ARF. Current evidence suggests that when nasal catheter oxygen therapy is insufficient for adequate oxygenation of patients with COVID-19-associated ARF, CPAP should be provided for prolonged periods. Subsequent escalation to IMV may be implemented if necessary.
Collapse
|
4
|
Bonnesen B, Jensen JUS, Jeschke KN, Mathioudakis AG, Corlateanu A, Hansen EF, Weinreich UM, Hilberg O, Sivapalan P. Management of COVID-19-Associated Acute Respiratory Failure with Alternatives to Invasive Mechanical Ventilation: High-Flow Oxygen, Continuous Positive Airway Pressure, and Noninvasive Ventilation. Diagnostics (Basel) 2021; 11:diagnostics11122259. [PMID: 34943496 PMCID: PMC8700515 DOI: 10.3390/diagnostics11122259] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/05/2023] Open
Abstract
Patients admitted to hospital with coronavirus disease 2019 (COVID-19) may develop acute respiratory failure (ARF) with compromised gas exchange. These patients require oxygen and possibly ventilatory support, which can be delivered via different devices. Initially, oxygen therapy will often be administered through a conventional binasal oxygen catheter or air-entrainment mask. However, when higher rates of oxygen flow are needed, patients are often stepped up to high-flow nasal cannula oxygen therapy (HFNC), continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), or invasive mechanical ventilation (IMV). BiPAP, CPAP, and HFNC may be beneficial alternatives to IMV for COVID-19-associated ARF. Current evidence suggests that when nasal catheter oxygen therapy is insufficient for adequate oxygenation of patients with COVID-19-associated ARF, CPAP should be provided for prolonged periods. Subsequent escalation to IMV may be implemented if necessary.
Collapse
Affiliation(s)
- Barbara Bonnesen
- Department of Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, University of Copenhagen, 2200 Copenhagen, Denmark; (B.B.); (J.-U.S.J.)
| | - Jens-Ulrik Stæhr Jensen
- Department of Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, University of Copenhagen, 2200 Copenhagen, Denmark; (B.B.); (J.-U.S.J.)
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Klaus Nielsen Jeschke
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, 2650 Hvidovre, Denmark; (K.N.J.); (E.F.H.)
| | - Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester M23 9LT, UK;
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK
| | - Alexandru Corlateanu
- Department of Respiratory Medicine, State University of Medicine and Pharmacy “Nicolae Testemitanu”, 2004 Chisinau, Moldova;
| | - Ejvind Frausing Hansen
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, 2650 Hvidovre, Denmark; (K.N.J.); (E.F.H.)
| | - Ulla Møller Weinreich
- Department of Respiratory Medicine, Aalborg University Hospital, University of Aalborg, 9100 Aalborg, Denmark;
- The Clinical Institute, Aalborg University, 9220 Aalborg, Denmark
| | - Ole Hilberg
- Department of Medicine, Little Belt Hospital, 7100 Vejle, Denmark;
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Pradeesh Sivapalan
- Department of Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, University of Copenhagen, 2200 Copenhagen, Denmark; (B.B.); (J.-U.S.J.)
- Correspondence: ; Tel.: +45-298-806-01
| |
Collapse
|
5
|
Li F, Yin R, Guo Q. Circulating angiopoietin-2 and the risk of mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis of 10 prospective cohort studies. Ther Adv Respir Dis 2021; 14:1753466620905274. [PMID: 32043429 PMCID: PMC7013116 DOI: 10.1177/1753466620905274] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Angiopoietin-2 (Ang-2), as one of the ligands of endothelial receptor Tie2, is known to be significant for vessel maturation and stabilization after birth. Previous studies showed the relationship between Ang-2 level and the risk of mortality in patients with acute respiratory distress syndrome (ARDS). However, the link between circulating Ang-2 and the risk of mortality in patients with ARDS varied in different investigations. RESULTS We performed a systematic review and meta-analysis of all available cohort studies regarding the association between baseline circulating Ang-2 and mortality in patients with ARDS. Among the 10 eligible studies, pooled odds ratio (OR) showed that high Ang-2 level contributed to ARDS mortality [OR = 1.56, 95% confidence interval (CI): 1.30-1.89, I2 = 76.2%]. Stratified analysis revealed that higher circulating Ang-2 was related to a 30% higher risk in the high-quality scores group (OR = 1.68, 95% CI: 1.33-2.68, I2 = 62.4%). The I2 of the bad compliance group decreased from 76.2% to 8.5%, which suggested that compliance is a significant source of heterogeneity. This association may be blunted by potential bias, although the results was not meaningfully changed by omitting only one study at a time. Further subgroup analysis and meta-regression support that compliance of patients also affects the results significantly, compared with the publication year, follow-up duration, the samples, or population characteristics. CONCLUSION Participants with higher baseline Ang-2 were at a higher risk for future risk of mortality in patients with ARDS. Higher circulating Ang-2 levels could independently predict the risk of mortality in patients with ARDS. However, further large scale prospective cohorts or even interventional studies are warranted to evaluate the diagnostic power of Ang-2 and its causative role on ARDS outcome. The reviews of this paper are available via the supplemental material section.
Collapse
Affiliation(s)
- Fengyuan Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Rulan Yin
- Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Qiang Guo
- Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 899# Pinghai Road, Suzhou, Jiangsu, 215006, China
| |
Collapse
|
6
|
Montrucchio G, Sales G, Rumbolo F, Palmesino F, Fanelli V, Urbino R, Filippini C, Mengozzi G, Brazzi L. Effectiveness of mid-regional pro-adrenomedullin (MR-proADM) as prognostic marker in COVID-19 critically ill patients: An observational prospective study. PLoS One 2021; 16:e0246771. [PMID: 33556140 PMCID: PMC7870047 DOI: 10.1371/journal.pone.0246771] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/25/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To test the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting mortality in COVID-19-ICU-patients. METHODS All consecutive COVID-19 adult patients admitted between March and June 2020 to the ICU of a referral, university hospital in Northern-Italy were enrolled. MR-proADM and routine laboratory test were measured within 48 hours from ICU admission, on day 3, 7 and 14. Survival curves difference with MR-proADM cut-off set to 1.8 nmol/L were tested using log-rank test. Predictive ability was compared using area under the curve and 95% confidence interval of different receiver-operating characteristics curves. RESULTS 57 patients were enrolled. ICU and overall mortality were 54.4%. At admission, lymphocytopenia was present in 86% of patients; increased D-dimer and CRP levels were found in 84.2% and 87.7% of patients respectively, while PCT values > 0.5 μg/L were observed in 47.4% of patients. MR-proADM, CRP and LDH were significantly different between surviving and non-surviving patients and over time, while PCT, D-dimer and NT-pro-BNP did not show any difference between the groups and over time; lymphocytes were different between surviving and non-surviving patients only. MR-proADM was higher in dying patients (2.65±2.33vs1.18±0.47, p<0.001) and a higher mortality characterized patients with MR-proADM >1.8 nmol/L (p = 0.016). The logistic regression model adjusted for age, gender, cardiovascular disease, diabetes mellitus and PCT values confirmed an odds ratio = 10.3 [95%CI:1.9-53.6] (p = 0.006) for MR-proADM >1.8 nmol/L and = 22.2 [95%CI:1.6-316.9] (p = 0.022) for cardiovascular disease. Overall, MR-proADM had the best predictive ability (AUC = 0.85 [95%CI:0.78-0.90]). CONCLUSIONS In COVID-19 ICU-patients, MR-proADM seems to have constantly higher values in non-survivor patients and predict mortality more precisely than other biomarkers. Repeated MR-proADM measurement may support a rapid and effective decision-making. Further studies are needed to better explain the mechanisms responsible of the increase in MR-proADM in COVID-19 patients.
Collapse
Affiliation(s)
- Giorgia Montrucchio
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
- Department of Surgical Science, University of Turin, Turin, Italy
- * E-mail:
| | - Gabriele Sales
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
| | - Francesca Rumbolo
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
| | | | - Vito Fanelli
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
- Department of Surgical Science, University of Turin, Turin, Italy
| | - Rosario Urbino
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
| | | | - Giulio Mengozzi
- Clinical Biochemistry Laboratory, Department of Laboratory Medicine, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
| | - Luca Brazzi
- Anestesia e Rianimazione 1U, Department of Anesthesia, Intensive Care and Emergency, ‘Città della Salute e della Scienza’ Hospital, Turin, Italy
- Department of Surgical Science, University of Turin, Turin, Italy
| |
Collapse
|
7
|
Sivapalan P, Bonnesen B, Jensen JU. Novel Perspectives Regarding the Pathology, Inflammation, and Biomarkers of Acute Respiratory Distress Syndrome. Int J Mol Sci 2020; 22:E205. [PMID: 33379178 PMCID: PMC7796016 DOI: 10.3390/ijms22010205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 12/29/2022] Open
Abstract
Acute respiratory distress syndrome (ARDS) is an acute inflammation of the lung resulting from damage to the alveolar-capillary membrane, and it is diagnosed using a combination of clinical and physiological variables. ARDS develops in approximately 10% of hospitalised patients with pneumonia and has a mortality rate of approximately 40%. Recent research has identified several biomarkers associated with ARDS pathophysiology, and these may be useful for diagnosing and monitoring ARDS. They may also highlight potential therapeutic targets. This review summarises our current understanding of those clinical biomarkers: (1) biomarkers of alveolar and bronchiolar injury, (2) biomarkers of endothelial damage and coagulation, and (3) biomarkers for treatment responses.
Collapse
Affiliation(s)
- Pradeesh Sivapalan
- Respiratory Medicine Section, Department of Internal Medicine, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark; (B.B.); (J.-U.J.)
| | | | | |
Collapse
|
8
|
van Paassen J, van Dissel JT, Hiemstra PS, Zwaginga JJ, Cobbaert CM, Juffermans NP, de Wilde RB, Stijnen T, de Jonge E, Klautz RJ, Arbous MS. Perioperative proADM-change is associated with the development of acute respiratory distress syndrome in critically ill cardiac surgery patients: a prospective cohort study. Biomark Med 2019; 13:1081-1091. [PMID: 31544475 DOI: 10.2217/bmm-2019-0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Biomarkers of acute respiratory distress syndrome (ARDS) after cardiac-surgery may help risk-stratification and management. Preoperative single-value proADM increases predictive capacity of scoring-system EuroSCORE. To include the impact of surgery, we aim to assess the predictive value of the perioperative proADM-change on development of ARDS in 40 cardiac-surgery patients. Materials & methods: ProADM was measured in nine sequential blood samples. The Berlin definition of ARDS was used. For data-analyses, a multivariate model of EuroSCORE and perioperative proADM-change, linear mixed models and logistic regression were used. Results: Perioperative proADM-change was associated with ARDS after cardiac-surgery, and it was superior to EuroSCORE. A perioperative proADM-change >1.5 nmol/l could predict ARDS. Conclusion: Predicting post-surgery ARDS with perioperative proADM-change enables clinicians to intensify lung-protective interventions and individualized fluid therapy to minimize secondary injury.
Collapse
Affiliation(s)
- Judith van Paassen
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap T van Dissel
- Department of Infectious Disease, Leiden University Medical Center, Leiden, The Netherlands.,Center for Infectious Disease Control, National Institute of Public Health & the Environment, Bilthoven, The Netherlands
| | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap Jan Zwaginga
- Department of Immunohematology & Blood transfusion, Leiden University Medical Center, Leiden, The Netherlands.,Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - Christa M Cobbaert
- Department of Clinical Chemistry & Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole P Juffermans
- Department of Intensive Care & Laboratory of Experimental Intensive Care & Anesthesiology (L.E.I.C.A.), Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Rob B de Wilde
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Theo Stijnen
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Evert de Jonge
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert J Klautz
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - M Sesmu Arbous
- Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
9
|
miRNA-1246 suppresses acute lung injury-induced inflammation and apoptosis via the NF-κB and Wnt/β-catenin signal pathways. Biomed Pharmacother 2018; 108:783-791. [DOI: 10.1016/j.biopha.2018.09.046] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/22/2018] [Accepted: 09/08/2018] [Indexed: 02/03/2023] Open
|
10
|
Wright JK, Hayford K, Tran V, Al Kibria GM, Baqui A, Manajjir A, Mahmud A, Begum N, Siddiquee M, Kain KC, Farzin A. Biomarkers of endothelial dysfunction predict sepsis mortality in young infants: a matched case-control study. BMC Pediatr 2018; 18:118. [PMID: 29571293 PMCID: PMC5866512 DOI: 10.1186/s12887-018-1087-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 03/07/2018] [Indexed: 02/15/2023] Open
Abstract
Background Reducing death due to neonatal sepsis is a global health priority, however there are limited tools to facilitate early recognition and treatment. We hypothesized that measuring circulating biomarkers of endothelial function and integrity (i.e. Angiopoietin-Tie2 axis) would identify young infants with sepsis and predict their clinical outcome. Methods We conducted a matched case-control (1:3) study of 98 young infants aged 0–59 days of life presenting to a referral hospital in Bangladesh with suspected sepsis. Plasma levels of Ang-1, Ang-2, sICAM-1, and sVCAM-1 concentrations were measured at admission. The primary outcome was mortality (n = 18); the secondary outcome was bacteremia (n = 10). Results Ang-2 concentrations at presentation were higher among infants who subsequently died of sepsis compared to survivors (aOR 2.50, p = 0.024). Compared to surviving control infants, the Ang-2:Ang-1 ratio was higher among infants who died (aOR 2.29, p = 0.016) and in infants with bacteremia (aOR 5.72, p = 0.041), and there was an increased odds of death across Ang-2:Ang-1 ratio tertiles (aOR 4.82, p = 0.013). Conclusions This study provides new evidence linking the Angiopoietin-Tie2 pathway with mortality and bacteremia in young infants with suspected sepsis. If validated in additional studies, markers of the angiopoietin-Tie2 axis may have clinical utility in risk stratification of infants with suspected sepsis. Electronic supplementary material The online version of this article (10.1186/s12887-018-1087-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Julie Korol Wright
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kyla Hayford
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vanessa Tran
- Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gulam Muhammed Al Kibria
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Abdullah Baqui
- International Centre for Maternal and Newborn Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ali Manajjir
- Department of Pediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh
| | - Arif Mahmud
- International Centre for Maternal and Newborn Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nazma Begum
- International Centre for Maternal and Newborn Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Mashuk Siddiquee
- Dhaka Shishu (Children's) Hospital, Sher-E-Bangla Nagar, Dhaka, Bangladesh
| | - Kevin C Kain
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Azadeh Farzin
- International Centre for Maternal and Newborn Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. .,Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
11
|
Bai C, Li T, Sun Q, Xin Q, Xu T, Yu J, Wang Y, Wei L. Protective effect of baicalin against severe burn‑induced remote acute lung injury in rats. Mol Med Rep 2017; 17:2689-2694. [PMID: 29207058 DOI: 10.3892/mmr.2017.8120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 10/03/2017] [Indexed: 11/05/2022] Open
Abstract
Baicalin exhibits antibacterial, anti‑viral, anti‑oxidative, antipyretic, analgesic, anti‑inflammatory and anti‑tumor properties. The chemical scavenges oxygen free radicals, protects the cardiovascular system and neurons, protects the liver, and has been used for the prevention and treatment of diabetes‑associated complications. The present study investigated the effect of baicalin on severe burn‑induced remote acute lung injury (ALI). The present study demonstrated that baicalin significantly decreased the lung wet‑to‑dry weight ratio, improved pulmonary histological alterations and reduced the expression of high mobility group protein B1 in the rat model of ALI. In addition, treatment with baicalin decreased tumor necrosis factor‑α, interleukin (IL)‑8, IL‑1β and IL‑18 concentrations in the serum, reduced myeloperoxidase activity and malondialdehyde content, and increased the level of superoxide dismutase in the serum in treated model rats with ALI. As a result, baicalin significantly suppressed nucleotide‑binding oligomerization, NACHT, LRR and PYD domains‑containing protein 3 (NLRP3), caspase‑1, nuclear factor‑κB and matrix metalloproteinase‑9 protein expression in the rat model of ALI. The results of the present study suggested that baicalin may serve a protective role against ALI in rats through the NLRP3 signaling pathway.
Collapse
Affiliation(s)
- Chongfeng Bai
- Postdoctoral Research Station of Qingdao University, Qingdao, Shandong 266071, P.R. China
| | - Tao Li
- Department of Cardiothoracic Surgery, 401 Hospital of People's Liberation Army, Qingdao, Shandong 266071, P.R. China
| | - Qing Sun
- Department of Hyperbaric Medicine, 401 Hospital of People's Liberation Army, Qingdao, Shandong 266071, P.R. China
| | - Qun Xin
- Department of General Surgery, 401 Hospital of People's Liberation Army, Qingdao, Shandong 266071, P.R. China
| | - Tongyi Xu
- Department of Cardiothoracic Surgery, 401 Hospital of People's Liberation Army, Qingdao, Shandong 266071, P.R. China
| | - Jinjian Yu
- Department of Cardiothoracic Surgery, 401 Hospital of People's Liberation Army, Qingdao, Shandong 266071, P.R. China
| | - Yun Wang
- Department of Cardiothoracic Surgery, 401 Hospital of People's Liberation Army, Qingdao, Shandong 266071, P.R. China
| | - Li Wei
- Postdoctoral Research Station of Qingdao University, Qingdao, Shandong 266071, P.R. China
| |
Collapse
|
12
|
Koh SH, Shin SG, Andrade MJ, Go RH, Park S, Woo CH, Lim JH. Long pentraxin PTX3 mediates acute inflammatory responses against pneumococcal infection. Biochem Biophys Res Commun 2017; 493:671-676. [PMID: 28864415 DOI: 10.1016/j.bbrc.2017.08.133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 01/01/2023]
Abstract
Streptococcus pneumoniae is an important human pathogen responsible for more than 2 million deaths annually worldwide. The airway epithelium acts as the first-line of defense against pneumococcal infections by regulating acute inflammation against invading pneumococcus. Despite the intact adaptive immunity, failure in early defense due to loss of pattern recognition receptors (PRRs) and/or acute phase proteins (APPs) results in detrimental damage and death. C-reactive protein (CRP), the first found APP, is a member of the pentraxin family of proteins and an important soluble PRR for pneumococcus. CRP and another short pentraxin, serum amyloid P, are critical for acute defense against pneumococcal infection. However, the role of the long pentraxin PTX3 in regulating pneumococcal infections is unknown. In this study, PTX3 expression was upregulated by pneumococcus in epithelial cells and in lungs of mice. In addition, PTX3 potentiated pneumococcal inflammation; overexpression of PTX3 enhanced pneumococcus-induced cytokine expression, whereas knock-down of PTX3 with siPTX3 inhibited the cytokine expression. Furthermore, PTX3 deficiency indeed ameliorated acute inflammation and protected mice against death following pneumococcal infection. Pneumococcal toxin pneumolysin was responsible for PTX3 expression and upregulated PTX3 expression via JNK MAPK signaling. These data implicate PTX3 as a novel therapeutic target for the control of acute inflammation by pneumococcus.
Collapse
Affiliation(s)
- Seo Hyun Koh
- Department of Microbiology, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Seul Gi Shin
- Department of Microbiology, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Maria Jose Andrade
- Department of Microbiology, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Ryun-Hee Go
- Department of Microbiology, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Seonghee Park
- Department of Physiology, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea
| | - Chang-Hoon Woo
- Department of Pharmacology and Smart-Aging Convergence Research Center, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Republic of Korea.
| | - Jae Hyang Lim
- Department of Microbiology, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea.
| |
Collapse
|
13
|
Podolanczuk AJ, Oelsner EC, Barr RG, Hoffman EA, Armstrong HF, Austin JHM, Basner RC, Bartels MN, Christie JD, Enright PL, Gochuico BR, Hinckley Stukovsky K, Kaufman JD, Hrudaya Nath P, Newell JD, Palmer SM, Rabinowitz D, Raghu G, Sell JL, Sieren J, Sonavane SK, Tracy RP, Watts JR, Williams K, Kawut SM, Lederer DJ. High attenuation areas on chest computed tomography in community-dwelling adults: the MESA study. Eur Respir J 2016; 48:1442-1452. [PMID: 27471206 DOI: 10.1183/13993003.00129-2016] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 05/07/2016] [Indexed: 01/02/2023]
Abstract
Evidence suggests that lung injury, inflammation and extracellular matrix remodelling precede lung fibrosis in interstitial lung disease (ILD). We examined whether a quantitative measure of increased lung attenuation on computed tomography (CT) detects lung injury, inflammation and extracellular matrix remodelling in community-dwelling adults sampled without regard to respiratory symptoms or smoking.We measured high attenuation areas (HAA; percentage of lung voxels between -600 and -250 Hounsfield Units) on cardiac CT scans of adults enrolled in the Multi-Ethnic Study of Atherosclerosis.HAA was associated with higher serum matrix metalloproteinase-7 (mean adjusted difference 6.3% per HAA doubling, 95% CI 1.3-11.5), higher interleukin-6 (mean adjusted difference 8.8%, 95% CI 4.8-13.0), lower forced vital capacity (FVC) (mean adjusted difference -82 mL, 95% CI -119--44), lower 6-min walk distance (mean adjusted difference -40 m, 95% CI -1--80), higher odds of interstitial lung abnormalities at 9.5 years (adjusted OR 1.95, 95% CI 1.43-2.65), and higher all cause-mortality rate over 12.2 years (HR 1.58, 95% CI 1.39-1.79).High attenuation areas are associated with biomarkers of inflammation and extracellular matrix remodelling, reduced lung function, interstitial lung abnormalities, and a higher risk of death among community-dwelling adults.
Collapse
Affiliation(s)
- Anna J Podolanczuk
- Dept of Medicine, Columbia University Medical Center, New York, NY, USA.,Both authors contributed equally to this work
| | - Elizabeth C Oelsner
- Dept of Medicine, Columbia University Medical Center, New York, NY, USA.,Both authors contributed equally to this work
| | - R Graham Barr
- Dept of Medicine, Columbia University Medical Center, New York, NY, USA.,Dept of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Eric A Hoffman
- Depts of Radiology, Medicine and Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Hilary F Armstrong
- Dept of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - John H M Austin
- Dept of Radiology, Columbia University Medical Center, New York, NY, USA
| | - Robert C Basner
- Dept of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Matthew N Bartels
- Dept of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Jason D Christie
- Dept of Medicine and the Center for Translational Lung Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Paul L Enright
- Dept of Epidemiology, University of Arizona, Tucson, AZ, USA
| | | | | | - Joel D Kaufman
- Dept of Medicine, University of Washington, Seattle, WA, USA
| | - P Hrudaya Nath
- Dept of Radiology, University of Alabama, South Birmingham, AL, USA
| | - John D Newell
- Depts of Radiology, Medicine and Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Scott M Palmer
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Dan Rabinowitz
- Dept of Statistics, Columbia University, New York, NY, USA
| | - Ganesh Raghu
- Dept of Medicine, University of Washington, Seattle, WA, USA
| | - Jessica L Sell
- Dept of Medicine, Columbia University Medical Center, New York, NY, USA
| | | | | | - Russell P Tracy
- Dept of Pathology, University of Vermont, Colchester, VT, USA
| | - Jubal R Watts
- Dept of Radiology, University of Alabama, South Birmingham, AL, USA
| | | | - Steven M Kawut
- Dept of Medicine and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David J Lederer
- Dept of Medicine, Columbia University Medical Center, New York, NY, USA .,Dept of Epidemiology, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|