Liu Meng, Li Hui, Xue Chun Xue, Gu Li, Qu Jiu Xin, Yu Xiao Min, Wang Yi Min, Liu Ying Mei, Cao Bin
Department of Infectious diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing, 100020, China.
Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, 100010, China.
Clin Respir J. 2018 Mar;12(3):974-985. doi: 10.1111/crj.12614. Epub 2017 Feb 15.
The inflammatory marker patterns of community-acquired Pneumonia (CAP) induced by different microorganisms in adult patients remained unclear.
We aim to explore the inflammatory marker patterns of adult CAP patients induced by different pathogens.
Adult CAP patients with definite etiologies were enrolled from September 2010 to June 2012. They were divided into three groups according to the causative pathogens: typical bacteria, Mycoplasma pneumoniae (MP), and viruses. Twenty-seven cytokines and bactericidal/permeability-increasing protein (BPI) levels of serum collected within 7 days onset in these groups were compared.
One hundred twenty-four cases were enrolled for serum detection and analysis, including 10 typical bacterial pneumonia patients, 56 cases with MP pneumonia and 58 with viral pneumonia. Three kinds (PDGF-BB, IP-10, RANTES) of 27 cytokines and BPI levels were significantly elevated in patients with acute pneumonia than healthy controls. Distinct inflammatory marker patterns were released by different pathogens: typical bacterial pneumonia patients had highest levels of BPI, IL-6, IL-8, IL-1rα; while patients caused by MP presented higher levels of PDGF-BB, IL-17A, G-CSF than those caused by viruses. Rhinovirus owned a higher inflammatory response level than the other viruses. The area under the curve (AUC) of PDGF-BB to differentiate MP and virus infection was biggest, which was 0.708.
Distinct inflammatory marker patterns were released by different pathogens during acute pneumonia. Significantly increased level of PDGF-BB was observed in acute pneumonia for the first time. It showed a better ability to differentiate MP and virus infection.
成人患者中由不同微生物引起的社区获得性肺炎（CAP）的炎症标志物模式尚不清楚。
我们旨在探讨不同病原体所致成人CAP患者的炎症标志物模式。
选取2010年9月至2012年6月病因明确的成人CAP患者。根据致病病原体将他们分为三组：典型细菌、肺炎支原体（MP）和病毒。比较这些组在发病7天内采集的血清中27种细胞因子和杀菌/通透性增加蛋白（BPI）的水平。
共纳入124例患者进行血清检测和分析，其中典型细菌性肺炎患者10例，MP肺炎患者56例，病毒性肺炎患者58例。27种细胞因子中的三种（血小板衍生生长因子-BB、干扰素γ诱导蛋白10、调节激活正常T细胞表达和分泌因子）和BPI水平在急性肺炎患者中显著高于健康对照。不同病原体释放出不同的炎症标志物模式：典型细菌性肺炎患者的BPI、白细胞介素-6、白细胞介素-8、白细胞介素-1受体拮抗剂水平最高；而MP所致患者的血小板衍生生长因子-BB、白细胞介素-17A、粒细胞集落刺激因子水平高于病毒所致患者。鼻病毒的炎症反应水平高于其他病毒。血小板衍生生长因子-BB区分MP和病毒感染的曲线下面积（AUC）最大，为0.708。
急性肺炎期间不同病原体释放出不同的炎症标志物模式。首次观察到急性肺炎中血小板衍生生长因子-BB水平显著升高。它在区分MP和病毒感染方面表现出较好的能力。
