Spoorenberg Simone M C, Vestjens Stefan M T, Voorn G P, van Moorsel Coline H M, Meek Bob, Zanen Pieter, Rijkers Ger T, Bos Willem Jan W, Grutters Jan C
Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands.
Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands.
PLoS One. 2018 Jan 11;13(1):e0190575. doi: 10.1371/journal.pone.0190575. eCollection 2018.
SP-D, YKL-40, CCL18 and CA 15-3 are pulmonary markers that have been extensively investigated in different chronic pulmonary diseases. However, in acute pulmonary diseases, such as community-acquired pneumonia (CAP), little is known about the course of these markers and their relationship with the aetiological agent. The aim of this study was to investigate the course of these four markers in CAP and to study influence of disease severity, aetiology and antibiotic use prior to admission on their course.
We included 291 adult patients hospitalised with CAP and 20 healthy controls. Measurements were performed in serum of day 0, 2, and 4, and at least 30 days after admission.
Our most important results were: 1) At all time-points, including 30 days after admission, YKL-40 and CCL18 levels were higher in CAP patients compared to healthy controls; and 2) Patients with CAP caused by an intracellular, atypical bacterium had lower YKL-40 and especially CCL18 levels on and during admission in comparison with other or unknown CAP aetiology.
Our findings suggest that these pulmonary markers could be useful to assess CAP severity and, especially YKL-40 and CCL18 by helping predict CAP caused by atypical pathogens.
表面活性蛋白-D（SP-D）、YKL-40、C-C趋化因子配体18（CCL18）和糖类抗原15-3（CA 15-3）是肺部标志物，已在不同慢性肺部疾病中得到广泛研究。然而，在急性肺部疾病，如社区获得性肺炎（CAP）中，对于这些标志物的变化过程及其与病原体的关系知之甚少。本研究的目的是调查这四种标志物在CAP中的变化过程，并研究疾病严重程度、病因以及入院前使用抗生素对其变化过程的影响。
我们纳入了291例因CAP住院的成年患者和20例健康对照。在入院第0天、第2天和第4天以及入院后至少30天采集血清进行检测。
我们最重要的结果是：1）在所有时间点，包括入院后30天，CAP患者的YKL-40和CCL18水平均高于健康对照；2）与其他病因或病因不明的CAP患者相比，由细胞内非典型细菌引起的CAP患者在入院时及住院期间的YKL-40水平较低，尤其是CCL18水平。
我们的研究结果表明，这些肺部标志物可能有助于评估CAP的严重程度，尤其是YKL-40和CCL18，有助于预测由非典型病原体引起的CAP。
