Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Clin Chim Acta. 2013 Apr 18;419:19-25. doi: 10.1016/j.cca.2013.01.011. Epub 2013 Feb 4.
Pneumonia is one of the most common causes of death from infectious diseases worldwide, and the most common fatal infection acquired in hospitals. Despite advances in prevention strategies, such as antibiotic therapies and intensive care, significant improvement in the mortality rate is still lacking. This high mortality is largely due to the limitations in current clinical practices and laboratory tests, which delay the timing of adequate antibiotic therapy. In recent years, many indicators (biomarkers) are present in scenarios where infectious pathogens invade into the body. These biomarkers, as reflected in specific biological responses to infections, have been reported to demonstrate the ability to facilitate the diagnosis, risk stratification, and management of pneumonia. This review provides a schematic overview of these new potential biomarkers based on the categories of (1) microorganisms and their derivatives, (2) inflammation mediators, (3) inflammation response proteins, and (4) stress-sensing proteins. In addition, approaches to identifying new biomarkers are also briefly introduced. Although no current biomarker can solely achieve a definitive diagnosis, many of them can be complemented, rather than replaced outright, in routine clinical practices to improve decision-making processes regarding pneumonia.
肺炎是全球范围内最常见的传染病死因之一，也是医院内最常见的致命感染。尽管预防策略（如抗生素治疗和重症监护）有所进步，但死亡率仍未见显著改善。这种高死亡率主要归因于当前临床实践和实验室检测的局限性，这延迟了适当抗生素治疗的时机。近年来，许多指标（生物标志物）出现在感染病原体侵入体内的情况下。这些生物标志物反映了对感染的特定生物学反应，据报道，它们具有促进肺炎的诊断、风险分层和管理的能力。本综述根据（1）微生物及其衍生物、（2）炎症介质、（3）炎症反应蛋白和（4）应激感应蛋白这几类，提供了这些新的潜在生物标志物的示意图概述。此外，还简要介绍了识别新生物标志物的方法。虽然目前没有任何一种生物标志物可以单独进行明确的诊断，但其中许多标志物可以在常规临床实践中进行补充，而不是完全替代，以改善肺炎相关决策过程。
