Rajas Olga, Ortega-Gómez Mara, Galván Román José María, Curbelo José, Fernández Jiménez Guillermo, Vega Piris Lorena, Rodríguez Salvanes Francisco, Arnalich Belén, Luquero Bueno Sergio, Díaz López Ana, de la Fuente Hortensia, Suárez Carmen, Ancochea Julio, Aspa Javier
Servicio de Neumología, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Hospital Universitario de la Princesa, IP, Madrid, España.
BMC Pulm Med. 2014 Dec 12;14:197. doi: 10.1186/1471-2466-14-197.
Late prognosis of Community-Acquired Pneumonia (CAP) patients is related to cardiovascular events. Persistence of inflammation-related markers, defined by high circulatory levels of interleukin 6 and 10 (IL-6/IL-10), is associated with a higher post-event mortality rate for CAP patients. However, association between these markers and other components of the immune response, and the risk of cardiovascular events, has not been adequately explored. The main objectives of this study are: 1) to quantify the incidence of cardiovascular disease, in the year post-dating their hospital admittance due to CAP and, 2) to describe the distribution patterns of a wide spectrum of inflammatory markers upon admittance to and release from hospital, and to determine their relationship with the incidence of cardiovascular disease.
METHODS/DESIGN: A cohort prospective study. All patients diagnosed and hospitalized with CAP will be candidates for inclusion. The study will take place in the Universitary Hospital La Princesa, Spain, during two years. Two samples of blood will be taken from each patient: the first upon admittance and the second one prior to release, in order to analyse various immune agents. The main determinants are: pro-adrenomedullin, copeptin, IL-1, IL-6, TNF-α, IL-17, IFN-γ, IL-10 and TGF-β, E-Selectin, ICAM-1, VCAM-1 and subpopulations of peripheral T lymphocytes (T regulator, Th1 and Th17), together with other clinical and analytical variables. Follow up will start at admittance and finish a year after discharge, registering incidence of death and cardiovascular events. The main objective is to establish the predictive power of different inflammatory markers in the prognosis of CAP, in the short and long term, and their relationship with cardiovascular disease.
The level of some inflammatory markers (IL-6/IL-10) has been proposed as a means to differentiate the degree of severity of CAP, but their association with cardiovascular risk is not well established. In this study we aim to define new inflammatory markers associated with cardiovascular disease that could be helpful for the prognosis of CAP patients, by describing the distribution of a wide spectrum of inflammatory mediators and analyzing their association with the incidence of cardiovascular disease and mortality one year after release from hospital.
社区获得性肺炎（CAP）患者的远期预后与心血管事件相关。炎症相关标志物的持续存在，以循环中白细胞介素6和10（IL-6/IL-10）的高水平为定义，与CAP患者事件后的较高死亡率相关。然而，这些标志物与免疫反应的其他成分以及心血管事件风险之间的关联尚未得到充分研究。本研究的主要目的是：1）量化因CAP入院后一年内心血管疾病的发病率，以及2）描述入院时和出院时多种炎症标志物的分布模式，并确定它们与心血管疾病发病率的关系。
方法/设计：一项队列前瞻性研究。所有诊断为CAP并住院的患者都将作为纳入对象。该研究将在西班牙拉普拉西达大学医院进行，为期两年。将从每位患者采集两份血样：第一份在入院时采集，第二份在出院前采集，以便分析各种免疫因子。主要测定指标包括：前肾上腺髓质素、 copeptin、IL-1、IL-6、TNF-α、IL-17、IFN-γ、IL-10和TGF-β、E-选择素、ICAM-1、VCAM-1以及外周T淋巴细胞亚群（调节性T细胞、Th1和Th17），以及其他临床和分析变量。随访将从入院开始，出院后一年结束，记录死亡和心血管事件的发生率。主要目的是确定不同炎症标志物在CAP短期和长期预后中的预测能力，以及它们与心血管疾病的关系。
一些炎症标志物（IL-6/IL-10）的水平已被提议作为区分CAP严重程度的一种手段，但其与心血管风险的关联尚未明确确立。在本研究中，我们旨在通过描述多种炎症介质的分布，并分析它们与出院后一年心血管疾病发病率和死亡率的关联，来确定与心血管疾病相关的新炎症标志物，这可能有助于CAP患者的预后评估。
