Clinical Significance of the Antimicrobial Peptide Cathelicidin in Acute Exacerbations of COPD

抗菌肽导管素在慢性阻塞性肺病急性加重中的临床意义

• 批准号: 9770541
• 负责人: Robert M Burkes
• 金额: $ 6.91万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-09 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9770541
• 关键词: Acute; Address; Admission activity; Age; Award; Biological Markers; Caring; Chemotactic Factors; Chronic Obstructive Airway Disease; Clinical; Cohort Analysis; Data; Data Analyses; Ensure; Epithelial Cells; Etiology; Future; Glucocorticoids; Hospitalization; Hospitals; Human Subject Research; Immune; Immune response; Incidence; Individual; Inflammation; Inflammatory; Inhalation; Innate Immune System; Investigation; Lead; Length of Stay; Lipopolysaccharides; Lung; Lung diseases; Measures; Mechanical ventilation; Mentors; Mentorship; Morbidity - disease rate; Outcome; Participant; Patients; Plasma; Play; Pneumonia; Property; Publications; Pulmonary Function Test/Forced Expiratory Volume 1; Race; Research; Research Design; Resources; Respiratory physiology; Risk; Role; Severities; Signal Transduction; Smoker; Smoking Status; Symptoms; Time; Time Factors; Tobacco; Training; Treatment Protocols; United States; Vitamin D; antimicrobial; antimicrobial peptide; career; cathelicidin; cathelicidin antimicrobial peptide; clinical Diagnosis; clinically significant; cohort; cost; experience; follow-up; health care service utilization; high risk; hospital readmission; macrophage; mortality; neutrophil; overtreatment; potential biomarker; prognostic; prognostic significance; prognostic value; prospective; readmission rates; response; sex; skills; specific biomarkers; trend

PROJECT ABSTRACT Acute exacerbations of COPD (AECOPD) contribute to the high morbidity and mortality of the condition. COPD exacerbations are costly, associated with increased healthcare utilization, and contribute to mortality in COPD. The antimicrobial peptide cathelicidin functions in the innate immune system by direct antimicrobial killing, immune cell signaling, and neutralization of lipopolysaccharide. In cohorts of stable COPD patients and smokers at-risk for COPD, cathelicidin levels are associated with lower lung function over time, increased incidence of pneumonia, and an increase in episodes of COPD exacerbations that require change in regular therapy. During an exacerbation of COPD, plasma cathelicidin levels increase, likely due to an acute inflammatory state. To date, there have been no investigations into the trend of plasma cathelicidin levels in AECOPD or the prognostic implications of plasma cathelicidin during hospitalization for AECOPD. This proposal will seek to define cathelicidin level and trend during hospitalization for COPD exacerbation and determine prognostic implication of cathelicidin levels during hospitalization for COPD exacerbation, including need for escalation of care and readmission rates. Successful completion of this proposal will determine the role of plasma cathelicidin levels in identifying high-risk cases of AECOPD.

项目摘要 COPD急性加重（AECOPD）导致该疾病的高发病率和死亡率。COPD 加重是昂贵的，与增加的医疗保健利用相关，并导致COPD的死亡率。 抗微生物肽凯萨林菌素在先天免疫系统中通过直接抗微生物杀伤起作用， 免疫细胞信号传导和脂多糖的中和。在稳定的COPD患者队列中， 对于有COPD风险的吸烟者，cathelicidin水平随着时间的推移与肺功能降低相关， 肺炎的发生率，以及需要改变常规治疗的COPD急性加重发作的增加 疗法在COPD恶化期间，血浆凯萨林菌素水平增加，可能是由于急性炎症反应。 炎症状态到目前为止，还没有研究血浆cathelicidin水平的趋势， AECOPD或AECOPD住院期间血浆组织蛋白酶抑制素的预后意义这 提案将寻求定义COPD急性加重住院期间的抗菌肽水平和趋势， 确定COPD急性加重住院期间凯萨林菌素水平的预后意义，包括 需要提高护理和再入院率。成功完成此提案将决定 血浆cathelicidin水平在识别AECOPD高危病例中的作用