Department of Pharmacy, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, China.
Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, China.
Sci Rep. 2021 Oct 26;11(1):21121. doi: 10.1038/s41598-021-00653-4.
Nicotinamide phosphoribosyltransferase (NAMPT) has been reported to be involved in infectious diseases, but it is unknown whether it plays a role in infectious pleural effusions (IPEs). We observed the levels of NAMPT in pleural effusions of different etiologies and investigated the clinical value of NAMPT in the differential diagnosis of infectious pleural effusions. A total of 111 patients with pleural effusion were enrolled in the study, including 25 parapneumonic effusions (PPEs) (17 uncomplicated PPEs, 3 complicated PPEs, and 5 empyemas), 30 tuberculous pleural effusions (TPEs), 36 malignant pleural effusions (MPEs), and 20 transudative effusions. Pleural fluid NAMPT levels were highest in the patients with empyemas [575.4 (457.7, 649.3) ng/ml], followed by those with complicated PPEs [113.5 (103.5, 155.29) ng/ml], uncomplicated PPEs [24.9 (20.2, 46.7) ng/ml] and TPEs [88 (19.4, 182.6) ng/ml], and lower in patients with MPEs [11.5 (6.5, 18.4) ng/ml] and transudative effusions [4.3 (2.6, 5.1) ng/ml]. Pleural fluid NAMPT levels were significantly higher in PPEs (P < 0.001) or TPEs (P < 0.001) than in MPEs. Moreover, Pleural fluid NAMPT levels were positively correlated with the neutrophil percentage and lactate dehydrogenase (LDH) levels and inversely correlated with glucose levels in both PPEs and TPEs, indicating that NAMPT was implicated in the neutrophil-associated inflammatory response in infectious pleural effusion. Further, multivariate logistic regression analysis showed pleural fluid NAMPT was a significant predictor distinguishing PPEs from MPEs [odds ratio (OR) 1.180, 95% confidence interval (CI) 1.052-1.324, P = 0.005]. Receiver-operating characteristic (ROC) analysis demonstrated that NAMPT was a promising diagnostic factor for the diagnosis of infectious effusions, with the areas under the curve for pleural fluid NAMPT distinguishing PPEs from MPEs, TPEs from MPEs, and IPEs (PPEs and TPEs) from NIPEs were 0.92, 0.85, and 0.88, respectively. In conclusion, pleural fluid NAMPT could be used as a biomarker for the diagnosis of infectious pleural effusions.
烟酰胺磷酸核糖基转移酶（NAMPT）已被报道参与感染性疾病，但尚不清楚其是否在感染性胸腔积液（IPEs）中发挥作用。我们观察了不同病因胸腔积液中的 NAMPT 水平，并研究了 NAMPT 在感染性胸腔积液鉴别诊断中的临床价值。共纳入 111 例胸腔积液患者，包括 25 例类肺炎性胸腔积液（PPEs）（17 例单纯性 PPEs、3 例复杂性 PPEs 和 5 例脓胸）、30 例结核性胸腔积液（TPEs）、36 例恶性胸腔积液（MPEs）和 20 例漏出性胸腔积液。脓胸患者胸腔液 NAMPT 水平最高[575.4（457.7，649.3）ng/ml]，其次是复杂性 PPEs[113.5（103.5，155.29）ng/ml]、单纯性 PPEs[24.9（20.2，46.7）ng/ml]和 TPEs[88（19.4，182.6）ng/ml]，MPEs 患者的水平较低[11.5（6.5，18.4）ng/ml]，漏出性胸腔积液患者的水平最低[4.3（2.6，5.1）ng/ml]。PPEs（P<0.001）或 TPEs（P<0.001）中 NAMPT 水平显著高于 MPEs。此外，PPEs 和 TPEs 中 NAMPT 水平与中性粒细胞百分比和乳酸脱氢酶（LDH）水平呈正相关，与葡萄糖水平呈负相关，提示 NAMPT 参与感染性胸腔积液中与中性粒细胞相关的炎症反应。进一步的多变量逻辑回归分析显示，胸腔液 NAMPT 是区分 PPEs 和 MPEs 的显著预测因子[比值比（OR）1.180，95%置信区间（CI）1.052-1.324，P=0.005]。受试者工作特征（ROC）分析表明，NAMPT 是诊断感染性渗出液的有前途的诊断因素，其曲线下面积（AUC）分别为区分 PPEs 与 MPEs、TPEs 与 MPEs 以及 IPEs（PPEs 和 TPEs）与 NIPEs 的 0.92、0.85 和 0.88。总之，胸腔液 NAMPT 可作为诊断感染性胸腔积液的生物标志物。
