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Jin Q, Liu C, Cao Y, Wang F. miR-486-5p predicted adverse outcomes of SCAP and regulated K. pneumonia infection via FOXO1. BMC Immunol 2024; 25:33. [PMID: 38834979 DOI: 10.1186/s12865-024-00624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024] Open
Abstract
PURPOSE Severe community-acquired pneumonia (SCAP) is a common respiratory system disease with rapid development and high mortality. Exploring effective biomarkers for early detection and development prediction of SCAP is of urgent need. The function of miR-486-5p in SCAP diagnosis and prognosis was evaluated to identify a promising biomarker for SCAP. PATIENTS AND METHODS The serum miR-486-5p in 83 patients with SCAP, 52 healthy individuals, and 68 patients with mild CAP (MCAP) patients were analyzed by PCR. ROC analysis estimated miR-486-5p in screening SCAP, and the Kaplan-Meier and Cox regression analyses evaluated the predictive value of miR-486-5p. The risk factors for MCAP patients developing SCAP were assessed by logistic analysis. The alveolar epithelial cell was treated with Klebsiella pneumonia to mimic the occurrence of SCAP. The targeting mechanism underlying miR-486-5p was evaluated by luciferase reporter assay. RESULTS Upregulated serum miR-486-5p screened SCAP from healthy individuals and MCAP patients with high sensitivity and specificity. Increasing serum miR-486-5p predicted the poor outcomes of SCAP and served as a risk factor for MCAP developing into SCAP. K. pneumonia induced suppressed proliferation, significant inflammation and oxidative stress in alveolar epithelial cells, and silencing miR-486-5p attenuated it. miR-486-5p negatively regulated FOXO1, and the knockdown of FOXO1 reversed the effect of miR-486-5p in K. pneumonia-treated alveolar epithelial cells. CONCLUSION miR-486-5p acted as a biomarker for the screening and monitoring of SCAP and predicting the malignancy of MCAP. Silencing miR-486-5p alleviated inflammation and oxidative stress induced by K. pneumonia via negatively modulating FOXO1.
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Affiliation(s)
- Qianqi Jin
- Department of Clinic Laboratory, The Sixth Hospital of Wuhan Affiliated Hospital of Jianghan University, Wuhan, 430015, China
| | - Chuanlan Liu
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry, Sichuan Engineering Laboratory for Plant-Sourced Drug, and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, 610041, China
| | - Yan Cao
- Department of Emergency Medical, Shanghai Sixth People's Hospital, No. 600, Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Feiyan Wang
- Department of Emergency Medical, Shanghai Sixth People's Hospital, No. 600, Yishan Road, Xuhui District, Shanghai, 200233, China.
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Ozbay S, Ayan M, Ozsoy O, Akman C, Karcioglu O. Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review. Diagnostics (Basel) 2023; 13:diagnostics13111869. [PMID: 37296721 DOI: 10.3390/diagnostics13111869] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Community-acquired pneumonia (CAP) is among the most common causes of death and one of the leading healthcare concerns worldwide. It can evolve into sepsis and septic shock, which have a high mortality rate, especially in critical patients and comorbidities. The definitions of sepsis were revised in the last decade as "life-threatening organ dysfunction caused by a dysregulated host response to infection". Procalcitonin (PCT), C-reactive protein (CRP), and complete blood count, including white blood cells, are among the most commonly analyzed sepsis-specific biomarkers also used in pneumonia in a broad range of studies. It appears to be a reliable diagnostic tool to expedite care of these patients with severe infections in the acute setting. PCT was found to be superior to most other acute phase reactants and indicators, including CRP as a predictor of pneumonia, bacteremia, sepsis, and poor outcome, although conflicting results exist. In addition, PCT use is beneficial to judge timing for the cessation of antibiotic treatment in most severe infectious states. The clinicians should be aware of strengths and weaknesses of known and potential biomarkers in expedient recognition and management of severe infections. This manuscript is intended to present an overview of the definitions, complications, and outcomes of CAP and sepsis in adults, with special regard to PCT and other important markers.
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Affiliation(s)
- Sedat Ozbay
- Department of Emergency Medicine, Sivas Numune Education and Research Hospital, Sivas 58040, Turkey
| | - Mustafa Ayan
- Department of Emergency Medicine, Sivas Numune Education and Research Hospital, Sivas 58040, Turkey
| | - Orhan Ozsoy
- Department of Emergency Medicine, Sivas Numune Education and Research Hospital, Sivas 58040, Turkey
| | - Canan Akman
- Department of Emergency Medicine, Canakkale Onsekiz Mart University, Canakkale 17100, Turkey
| | - Ozgur Karcioglu
- Department of Emergency Medicine, University of Health Sciences, Taksim Education and Research Hospital, Beyoglu, Istanbul 34098, Turkey
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Ramgopal S, Ambroggio L, Lorenz D, Shah SS, Ruddy RM, Florin TA. Incorporation of biomarkers into a prediction model for paediatric radiographic pneumonia. ERJ Open Res 2023; 9:00339-2022. [PMID: 36891073 PMCID: PMC9986752 DOI: 10.1183/23120541.00339-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The aim of this study was to evaluate biomarkers to predict radiographic pneumonia among children with suspected lower respiratory tract infections (LRTI). Methods We performed a single-centre prospective cohort study of children 3 months to 18 years evaluated in the emergency department with signs and symptoms of LRTI. We evaluated the incorporation of four biomarkers (white blood cell count, absolute neutrophil count, C-reactive protein (CRP) and procalcitonin), in isolation and in combination, with a previously developed clinical model (which included focal decreased breath sounds, age and fever duration) for an outcome of radiographic pneumonia using multivariable logistic regression. We evaluated the improvement in performance of each model with the concordance (c-) index. Results Of 580 included children, 213 (36.7%) had radiographic pneumonia. In multivariable analysis, all biomarkers were statistically associated with radiographic pneumonia, with CRP having the greatest adjusted odds ratio of 1.79 (95% CI 1.47-2.18). As an isolated predictor, CRP at a cut-off of 3.72 mg·dL-1 demonstrated a sensitivity of 60% and a specificity of 75%. The model incorporating CRP demonstrated improved sensitivity (70.0% versus 57.7%) and similar specificity (85.3% versus 88.3%) compared to the clinical model when using a statistically derived cutpoint. In addition, the multivariable CRP model demonstrated the greatest improvement in concordance index (0.780 to 0.812) compared with a model including only clinical variables. Conclusion A model consisting of three clinical variables and CRP demonstrated improved performance for the identification of paediatric radiographic pneumonia compared with a model with clinical variables alone.
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Affiliation(s)
- Sriram Ramgopal
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lilliam Ambroggio
- Department of Pediatrics, University of Colorado and Sections of Emergency Medicine and Hospital Medicine, Children's Hospital Colorado, Aurora, CO, USA
| | - Douglas Lorenz
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Samir S Shah
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Richard M Ruddy
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Todd A Florin
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Xie S, Wang J, Tuo W, Zhuang S, Cai Q, Yao C, Han F, Zhu H, Xiang Y, Yuan C. Serum level of S100A8/A9 as a biomarker for establishing the diagnosis and severity of community-acquired pneumonia in children. Front Cell Infect Microbiol 2023; 13:1139556. [PMID: 37180431 PMCID: PMC10172663 DOI: 10.3389/fcimb.2023.1139556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023] Open
Abstract
Background S100A8/A9, which is a member of S100 proteins, may be involved in the pathophysiology of Community-acquired pneumonia (CAP) that seriously threatens children's health. However, circulating markers to assess the severity of pneumonia in children are yet to be explored. Therefore, we aimed to investigate the diagnostic performance of serum S100A8/A9 level in determining the severity of CAP in children. Methods In this prospective and observational study, we recruited 195 in-hospital children diagnosed with CAP. In comparison, 63 healthy children (HC) and 58 children with non-infectious pneumonia (pneumonitis) were included as control groups. Demographic and clinical data were collected. Serum S100A8/A9 levels, serum pro-calcitonin concentrations, and blood leucocyte counts were quantified. Results The serum S100A8/A9 levels in patients with CAP was 1.59 ± 1.32 ng/mL, which was approximately five and two times higher than those in healthy controls and those in children with pneumonitis, respectively. Serum S100A8/A9 was elevated parallelly with the clinical pulmonary infection score. The sensitivity, specificity, and Youden's index of S100A8/A9 ≥1.25 ng/mL for predicting the severity of CAP in children was optimal. The area under the receiver operating characteristic curve of S100A8/A9 was the highest among the indices used to evaluate severity. Conclusions S100A8/A9 may serve as a biomarker for predicting the severity of the condition in children with CAP and establishing treatment grading.
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Affiliation(s)
- Si Xie
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Wang
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenbin Tuo
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shihao Zhuang
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qinzhen Cai
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cong Yao
- Health Care Department, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Han
- Department of Pediatric Respiratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongmin Zhu
- Department of Neurology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Hongmin Zhu, ; Yun Xiang, ; Chunhui Yuan,
| | - Yun Xiang
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Hongmin Zhu, ; Yun Xiang, ; Chunhui Yuan,
| | - Chunhui Yuan
- Department of Laboratory Medicine, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Hongmin Zhu, ; Yun Xiang, ; Chunhui Yuan,
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Bekis Bozkurt H, Gümüs A, Ergüven M. Is Serum Endocan Level an Indicator of the Severity of Childhood Community-Acquired Pneumonia? J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1743576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Objective We aimed to investigate the relationship between serum endocan, procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), neutrophil/lymphocyte ratios (NLR), and the severity of the disease in childhood community-acquired pneumonia (CAP) cases.
Methods This cross-sectional designed study included 30 pneumonia cases and 30 severe pneumonia cases aged between 3 months and 18 years who were hospitalized and treated in our hospital with the diagnosis of CAP. We also included 30 healthy controls in the same age range. Pearson's correlation and receiver operating characteristic (ROC) curve analyzes were performed.
Results PCT, endocan, NLR, and CRP levels were found to be significantly higher in patients with severe pneumonia. Sensitivity and specificity values in detecting pneumonia were 72.5 and 93% for PCT, 78.4 and 83.3% for CRP, 78.4 and 76.7% for endocan, and 64.7 and 63.3% for NLR. However, the area under the curve in ROC analysis were 0.821, 0.840, 0.842, and 0.670 for PCT, CRP, endocan, and NLR respectively.
Conclusion Endocan may be a marker of the diagnosis of pneumonia and not clinical severity, but studies are needed in large patient populations.
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Affiliation(s)
| | - Abdullah Gümüs
- Department of Microbiology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Müferet Ergüven
- Department of Pediatrics, Faculty of Medicine, Kafkas University, Kars, Turkey
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Florin TA, Williams DJ. PRO: Procalcitonin has clinical utility in children with community-acquired pneumonia. JAC Antimicrob Resist 2021; 3:dlab158. [DOI: 10.1093/jacamr/dlab158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
Procalcitonin (PCT) is a useful, albeit imperfect, diagnostic aid that can help clinicians make more informed decisions around antibiotic use in children with lower respiratory tract infections (LRTI), including community-acquired pneumonia (CAP). Recent data suggest that a very low PCT concentration has a high negative predictive value to identify a population of children at low risk of typical bacterial infections. Although the preponderance of data on the clinical utility of PCT in LRTI come from adult studies, the potential for benefit is likely greatest in paediatric CAP and other LRTIs where viral aetiologies predominate, yet antibiotics are frequently prescribed.
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Affiliation(s)
- Todd A Florin
- Department of Pediatrics, Northwestern University Feinberg School of Medicine and Division of Pediatric Emergency Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Derek J Williams
- Department of Pediatrics, Vanderbilt University School of Medicine and Division of Hospital Medicine, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA
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