Serum activity of indoleamine 2,3-dioxygenase predicts prognosis of community-acquired pneumonia
Serum activity of indoleamine 2,3-dioxygenase predicts prognosis of community-acquired pneumonia
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DOI：
10.1016/j.jinf.2011.07.003
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发表时间：
2011-09-01
影响因子：
28.2
通讯作者：
Chida, Kingo
中科院分区：
文献类型：
--
作者：
Suzuki, Yuzo;Suda, Takafumi;Chida, Kingo
目的：吲哚胺2，3-双加氧酶(IDO)催化犬尿氨酸(Kyn)途径中色氨酸(Trp)降解的限速步骤。通过耗尽色氨酸，IDO在诱导免疫抑制和耐受方面发挥了关键作用。目的：探讨社区获得性肺炎(CAP)患者血清IDO活性(Kyn/Trp比值)及其临床意义。结果：慢性盆腔炎患者血清Kyn浓度显著高于对照组(P<；0.0001)，Trp浓度显著低于对照组(P<；0.0001)。因此，患者组的IDO活性显著高于对照组(P<；0.0001)。IDO活性与肺炎严重程度指数和CURB65有很好的相关性(分别为p=0.0005和p<；0.0001)。多因素分析显示，死亡患者IDO活性和Kyn浓度显著升高，并可预测死亡率。结论：CAP患者IDO活性升高，且与病情严重程度和预后有关。提示IDO活性可预测CAP的预后。(C)2011年英国感染协会。爱思唯尔有限公司出版。保留所有权利。
Objectives: Indoleamine 2,3-dioxygenase (IDO) catalyzes the rate-limiting step of tryptophan (Trp) degradation in the kynurenine (Kyn) pathway. By depleting Trp, IDO plays a critical role in inducing immune suppression and tolerance. The aim of present study was to investigate serum IDO activity, determined by Kyn-to-Trp ratio (Kyn/Trp ratio), in community-acquired pneumonia (CAP) and to examine its clinical significance.Metods: This study subjects consisted of 129 consecutive patients with CAP and 64 healthy controls. The concentrations of Kyn and Trp were measured simultaneously by liquid chromatography/electrospray ionization tandem mass spectrometry.Results: The CAP patients had significantly higher Kyn concentrations and significant lower Trp concentrations than the controls (p < 0.0001 and p < 0.0001, respectively). Accordingly, IDO activity was significantly higher (2.4-fold) in the patients than in the controls (p < 0.0001). IDO activity correlated well with PSI (Pneumonia Severity Index) and CURB65 (p = 0.0005 and p < 0.0001, respectively). Moreover, the IDO activity and Kyn concentration were significantly higher in the nonsurvivors and were found to predict mortality in multivariate analysis.Conclusions: IDO activity was increased in CAP, and this activity was associated with the severity and outcome of this disease. These results suggest that IDO activity can predict prognosis of CAP. (C) 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.