Contrasting Inflammatory Responses in Severe and Non-severe Community-acquired Pneumonia
Contrasting Inflammatory Responses in Severe and Non-severe Community-acquired Pneumonia
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DOI：
10.1007/s10753-014-9840-2
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发表时间：
2014-08-01
期刊：
影响因子：
5.1
通讯作者：
Bordon, Jose
中科院分区：
文献类型：
--
作者：
Fernandez-Botran, Rafael;Uriarte, Silvia M.;Bordon, Jose
本研究的目的是比较重症与非重症社区获得性肺炎 (CAP) 患者的全身和局部细胞因子谱以及中性粒细胞反应。根据肺炎严重程度指数（PSI）将住院的 CAP 患者分为非重症（PSI < 91 分）或重症（PSI 千分之一日元欧元千分之 91 分）。入院时采集血液和痰样本。与非重症CAP患者相比，重症CAP组的血浆促炎细胞因子和抗炎细胞因子水平较高，但痰液中促炎细胞因子浓度较低。与健康对照相比，CAP 患者的血液中性粒细胞功能反应升高。然而，与非重症组相比，重症 CAP 患者的中性粒细胞呼吸爆发活动减少。结果表明，严重 CAP 患者未能产生强大的局部促炎症反应，而是表现出更显着的全身炎症反应，这表明 CAP 严重程度的关键驱动因素可能是患者产生最佳局部炎症反应的能力。
The objective of this study was to compare systemic and local cytokine profiles and neutrophil responses in patients with severe versus non-severe community-acquired pneumonia (CAP). Hospitalized patients with CAP were grouped according to the pneumonia severity index (PSI), as non-severe (PSI < 91 points) or severe (PSI a parts per thousand yenaEuro parts per thousand 91 points). Blood and sputum samples were collected upon admission. Compared to non-severe CAP patients, the severe CAP group showed higher plasma levels of pro- and anti-inflammatory cytokines but in contrast, lower sputum concentrations of pro-inflammatory cytokines. Blood neutrophil functional responses were elevated in CAP patients compared to healthy controls. However, neutrophils from severe CAP patients showed reduced respiratory burst activity compared to the non-severe group. Results indicate that patients with severe CAP fail to mount a robust local pro-inflammatory response but exhibit instead a more substantial systemic inflammatory response, suggesting that a key driver of CAP severity may be the ability of the patient to generate an optimal local inflammatory response.