Low plasma level of cathelicidin antimicrobial peptide (hCAP18) predicts increased infectious disease mortality in patients undergoing hemodialysis.
Low plasma level of cathelicidin antimicrobial peptide (hCAP18) predicts increased infectious disease mortality in patients undergoing hemodialysis.
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DOI：
10.1086/596314
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发表时间：
2009-02-15
期刊：
影响因子：
--
通讯作者：
Thadhani R
中科院分区：
文献类型：
--
作者：
Gombart AF;Bhan I;Borregaard N;Tamez H;Camargo CA Jr;Koeffler HP;Thadhani R
人抗菌肽抗菌蛋白（hCAP 18）是一种抗菌和免疫调节肽，具有多效性作用，并受维生素D的转录调控。由于维生素D类似物的管理已与终末期肾病患者的死亡率降低，我们假设，低hCAP 18水平将确定那些谁是在增加的死亡风险归因于感染，而接受血液透析。我们在一个前瞻性队列（n = 10，044）中进行了一项病例对照研究，该队列包括开始血液透析的患者。病例患者（n = 81）为1年内死于感染性疾病的患者;对照患者（n = 198）为接受透析时存活至少1年的患者。病例患者和对照患者中hCAP 18的平均（± SD）基线水平分别为539 ± 278 ng/mL和650 ± 343 ng/mL（P = .006）。hCAP 18水平与1，25-二羟维生素D水平相关性最大（r = 0.23; P = 0.053），但与25-羟维生素D水平无关（r =-0.06; P = 0.44）。hCAP 18水平处于最低三分位数的患者因感染导致死亡的风险增加2倍（比值比，2.1; 95%置信区间，1.2-3.5）;在多变量调整后，这种关系仍然具有统计学意义（比值比，3.7; 95%置信区间，1.2-11.2）。在开始慢性血液透析的个体中，低基线水平的hCAP 18（一种维生素D调节的抗菌蛋白）与感染所致死亡风险增加独立相关。
Human cathelicidin antimicrobial protein (hCAP18) is an antimicrobial and immunomodulatory peptide that has pleiotropic effects and is transcriptionally regulated by vitamin D. Because the administration of vitamin D analogues has been linked to decreased mortality among patients with end-stage renal disease, we hypothesized that low hCAP18 levels would identify those who are at increased risk of death attributable to infection while undergoing hemodialysis. We performed a case-control study nested in a prospective cohort of patients (n = 10,044) initiating incident hemodialysis. Case patients (n = 81) were those who died of an infectious disease within 1 year; control patients (n = 198) were those who survived at least 1 year while undergoing dialysis. Mean (± SD) baseline levels of hCAP18 in case patients and control patients were 539 ± 278 ng/mL and 650 ± 343 ng/mL, respectively (P = .006). hCAP18 levels had amodest correlation with 1,25-dihydroxyvitamin D levels (r = 0.23; P = .053) but not with 25-hydroxyvitamin D levels (r = −0.06; P = .44). Patients with hCAP18 levels in the lowest tertile had a 2-fold increased risk (odds ratio, 2.1; 95% confidence interval, 1.2–3.5) of death attributable to infection; after multivariable adjustment, this relationship remained statistically significant (odds ratio, 3.7; 95% confidence interval, 1.2–11.2). In individuals initiating chronic hemodialysis, low baseline levels of hCAP18, a vitamin D–regulated antimicrobial protein, are independently associated with an increased risk of death attributable to infection.
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影响因子：
4.8
作者：
Gombart, AF;Borregaard, N;Koeffler, HP
通讯作者：
Koeffler, HP
DOI：
10.1073/pnas.97.16.8856
发表时间：
2000-08-01
影响因子：
11.1
作者：
Hancock, REW;Scott, MG
通讯作者：
Scott, MG
影响因子：
56.9
作者：
Liu, PT;Stenger, S;Modlin, RL
通讯作者：
Modlin, RL
影响因子：
13.6
作者：
Teng, M;Wolf, M;Thadhani, R
通讯作者：
Thadhani, R
DOI：
10.1161/01.atv.0000223901.08459.57
发表时间：
2006-07-01
影响因子：
8.7
作者：
Edfeldt, Kristina;Agerberth, Birgitta;Yan, Zhong-qun
通讯作者：
Yan, Zhong-qun