Skelly Michael J, Holzman Robert S, Merali Salim
Department of Infectious Diseases, Lincoln Medical and Mental Health Center, Bronx, New York 10451, USA.
Clin Infect Dis. 2008 Feb 1;46(3):467-71. doi: 10.1086/525854.
S-adenosylmethionine (AdoMet) is a key molecule involved in methylation reactions and polyamine synthesis. Pneumocystis carinii are unable to synthesize this molecule and have been shown to scavenge this metabolic intermediate from the plasma of rats during active infection. A prior study involving humans strongly suggested that low levels of plasma AdoMet are sensitive and specific indicators of acute infection.
From March 2004 through January 2006, we collected plasma AdoMet levels from patients with human immunodeficiency virus (HIV) infection and either confirmed Pneumocystis carinii pneumonia (PCP), confirmed pulmonary tuberculosis, or confirmed bacterial pneumonia. We compared levels in patients with PCP with those in patients with other diseases and also monitored changes in levels during treatment of PCP.
Initial AdoMet levels were significantly lower in patients with PCP, and there was no overlap between the groups. Among patients with PCP, levels of AdoMet increased with successful treatment.
Measurement of plasma AdoMet levels in patients with HIV infection who have pulmonary infections can identify those with PCP.
S-腺苷甲硫氨酸（AdoMet）是参与甲基化反应和多胺合成的关键分子。卡氏肺孢子虫无法合成该分子，并且已证实在活跃感染期间可从大鼠血浆中清除这种代谢中间体。一项先前涉及人类的研究强烈表明，血浆AdoMet水平低是急性感染的敏感且特异的指标。
从2004年3月至2006年1月，我们收集了人类免疫缺陷病毒（HIV）感染患者且确诊患有卡氏肺孢子虫肺炎（PCP）、确诊肺结核或确诊细菌性肺炎患者的血浆AdoMet水平。我们将PCP患者的水平与其他疾病患者的水平进行比较，并在PCP治疗期间监测水平变化。
PCP患者的初始AdoMet水平显著较低，且两组之间无重叠。在PCP患者中，AdoMet水平随治疗成功而升高。
对患有肺部感染的HIV感染患者测量血浆AdoMet水平可识别出患有PCP的患者。
