血清白细胞介素-17 预测社区获得性肺炎患者的严重程度和预后:一项前瞻性队列研究。

Serum interleukin-17 predicts severity and prognosis in patients with community acquired pneumonia: a prospective cohort study.

机构信息

Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Furong Road No 678, Hefei, 230601, Anhui, China.

Department of Pharmacy, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.

出版信息

BMC Pulm Med. 2021 Dec 2;21(1):393. doi: 10.1186/s12890-021-01770-6.

Abstract

BACKGROUND

Some studies previously demonstrated that interleukin-17 (IL-17) involves in pulmonary diseases progression. Nevertheless, the role of IL-17 in community-acquired pneumonia (CAP) remains unknown. This study aims to examine the correlations between serum IL-17 with the severity and prognosis in CAP patients through a prospective cohort study.

METHODS

All 239 CAP patients were recruited. Serum IL-17 was detected by enzyme-linked immunosorbent assay (ELISA). The CAP severity was evaluated through CAP severity scores, including CURB-65, CRB-65, PSI, SMART-COP, CURXO and APACHE II.

RESULTS

Serum IL-17 was gradually increased consistent with the severity of CAP. Correlative analysis suggested that serum IL-17 was associated with clinical physiologic indicators among CAP patients. Logistic regression indicated that serum IL-17 was positively related to CAP severity scores. Additionally, the prognostic outcomes were tracked among CAP patients. The levels of IL-17 on admission were significantly increased in CAP patients with ICU admission, mechanical ventilation, vasoactive agent, death and longer hospitalization days. Logistic regression analyses revealed serum higher IL-17 on admission elevated the risks of vasoactive agent usage and longer hospital stays in CAP patients. The cut-off concentrations of serum IL-17 for death, ICU admission, mechanical ventilation and ≥ 14 hospital stays were 86.80 ng/mL, 84.92 ng/mL, 84.92 ng/mL and 60.29 ng/mL respectively.

CONCLUSIONS

Serum IL-17 on admission is positively associated with the severity and poor prognosis among CAP patients, revealing that IL-17 may implicate in the pathological process of CAP. Therefore, serum IL-17 may become an effective biomarker for diagnosis, prognosis and therapy for CAP patients.

摘要

背景

一些研究表明白细胞介素-17(IL-17)参与了肺部疾病的进展。然而,IL-17 在社区获得性肺炎(CAP)中的作用仍不清楚。本研究通过前瞻性队列研究旨在探讨血清 IL-17 与 CAP 患者严重程度和预后的相关性。

方法

共招募了 239 例 CAP 患者。通过酶联免疫吸附试验(ELISA)检测血清 IL-17。采用 CAP 严重程度评分,包括 CURB-65、CRB-65、PSI、SMART-COP、CURXO 和 APACHE II,对 CAP 严重程度进行评估。

结果

血清 IL-17 随着 CAP 严重程度的增加而逐渐升高。相关分析表明,血清 IL-17 与 CAP 患者的临床生理指标有关。Logistic 回归分析表明,血清 IL-17 与 CAP 严重程度评分呈正相关。此外,还对 CAP 患者的预后结果进行了跟踪。在入住 ICU、机械通气、血管活性药物、死亡和住院时间较长的 CAP 患者中,入院时 IL-17 的水平显著升高。Logistic 回归分析显示,入院时血清中较高的 IL-17 水平增加了 CAP 患者使用血管活性药物和住院时间延长的风险。死亡、入住 ICU、机械通气和住院时间≥14 天的血清 IL-17 截断浓度分别为 86.80ng/ml、84.92ng/ml、84.92ng/ml 和 60.29ng/ml。

结论

入院时的血清 IL-17 与 CAP 患者的严重程度和不良预后呈正相关,表明 IL-17 可能参与了 CAP 的病理过程。因此,血清 IL-17 可能成为 CAP 患者诊断、预后和治疗的有效生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72d9/8638345/3e378f6f203d/12890_2021_1770_Fig1_HTML.jpg

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