Microvesicle Tissue Factor Activity and Interleukin-8 Levels are Associated with Mortality in Patients with Influenza A/H1N1 Infection.
Microvesicle Tissue Factor Activity and Interleukin-8 Levels are Associated with Mortality in Patients with Influenza A/H1N1 Infection.
复制标题
DOI：
10.1097/ccm.0000000000001584
复制
发表时间：
2016-07
影响因子：
8.8
通讯作者：
Mackman N
中科院分区：
文献类型：
--
作者：
Rondina MT;Tatsumi K;Bastarache JA;Mackman N
To identify plasma biomarkers that can be early predictors of mortality in critically ill patients with primary influenza A/H1N1. A prospective, multicenter, case-cohort pilot study. Three academic ICUs. Fifteen patients with primary influenza A/H1N1 that included 7 survivors and 8 non-survivors. For comparison, age- and gender-matched healthy controls (n=27) were also studied. Plasma was prepared from whole blood drawn upon ICU admission in influenza patients (ICU day 1). Microvesicle tissue factor (MV-TF) activity, thrombin-antithrombin complexes (TATc), and D-dimers were measured as procoagulant markers and markers of activation of coagulation. Plasma cytokine levels were measured on the same blood samples in a subset of 12 influenza patients using the Luminex Multi-Analyte Profiling system. Patients were followed for the primary outcome of 28-day mortality. The average admission APACHE II score of the patients was 25.5±9.3, 60% of patients had shock, and the 28-day mortality rate was 53.3% (n=8/15). Influenza patients had dysregulated indices of coagulation and inflammation compared to controls. Among the markers of activation of coagulation measured on ICU day 1, only increased MV-TF activity was significantly associated with subsequent influenza-related mortality (5.6±1.2 pg/ml in non-survivors vs. 1.8±0.8 pg/mL in survivors, p < 0.05). IL-8 was significantly higher in non-survivors compared with survivors (71.8±29.1 pg/ml, n=5 vs. 17.3±3.7 pg/mL, n=7, p < 0.05). In addition, MV-TF activity and IL-8 levels were significantly and positively correlated (r2 = 0.60, P=0.003). Other cytokines, TATc, and D-dimer were not different between non-survivors and survivors and did not correlate with illness severity or mortality. This study identifies an association between plasma IL-8 and MV-TF activity measured upon admission in patients with severe, primary influenza A/H1N1 infection and subsequent mortality. Thus, these biomarkers may serve as very early prognostic markers for patients with influenza A/H1N1.
