Yao Meng-Xing, Cheng Jia-Yi, Liu Ying, Sun Jing, Hua Dong-Xu, He Qi-Yuan, Liu Hong-Yan, Fu Lin, Zhao Hui
Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Toxicology, Anhui Medical University, Hefei, China.
Front Med (Lausanne). 2022 Aug 11;9:939002. doi: 10.3389/fmed.2022.939002. eCollection 2022.
Cysteine-rich 61 (CYR61) is implicated in many pulmonary diseases. However, the relationship between CYR61 and community-acquired pneumonia (CAP) patients was unknown. This research aimed to estimate the correlations of serum CYR61 with severity and prognosis in CAP patients through a prospective cohort study.
All 541 CAP patients were enrolled in this study. Fasting venous blood was collected. Clinical characteristics and demographic information were obtained. CYR61 and inflammatory cytokines were detected in serum using ELISA.
Serum CYR61 was gradually increased in parallel with severity scores in CAP patients. Correlative analysis indicated that serum CYR61 was strongly associated with many clinical parameters in CAP patients. Moreover, mixed logistic and linear regression models found that there were positive correlations between serum CYR61 and CAP severity scores after adjusted for age, BMI, and respiratory rate. Stratified analyses suggested that age affected the associations between serum CYR61 and severity scores. On admission, higher serum CYR61 levels elevated the risks of mechanical ventilation, vasoactive agent, ICU admission, death, and longer hospital stays during hospitalization. Moreover, serum CYR61 in combination with severity scores upregulated the predictive capacities for severity and death than single serum CYR61 or severity scores in CAP patients.
There are significantly positive dose-response associations of serum CYR61 on admission with the severity and adverse prognostic outcomes, demonstrating that CYR61 is involved in the pathophysiology of CAP. Serum CYR61 may be used as a potential biomarker for the diagnosis and prognosis in CAP patients.
富含半胱氨酸的61蛋白（CYR61）与多种肺部疾病有关。然而，CYR61与社区获得性肺炎（CAP）患者之间的关系尚不清楚。本研究旨在通过一项前瞻性队列研究评估血清CYR61与CAP患者病情严重程度及预后的相关性。
本研究纳入了541例CAP患者。采集空腹静脉血。获取临床特征和人口统计学信息。采用酶联免疫吸附测定法（ELISA）检测血清中的CYR61和炎性细胞因子。
CAP患者血清CYR61水平随病情严重程度评分的升高而逐渐升高。相关性分析表明，血清CYR61与CAP患者的许多临床参数密切相关。此外，混合逻辑回归和线性回归模型发现，在调整年龄、体重指数和呼吸频率后，血清CYR61与CAP严重程度评分呈正相关。分层分析表明，年龄影响血清CYR61与严重程度评分之间的关联。入院时，血清CYR61水平较高会增加机械通气、使用血管活性药物、入住重症监护病房（ICU）、死亡的风险，并延长住院时间。此外，与单独的血清CYR61或严重程度评分相比，血清CYR61与严重程度评分联合使用可提高对CAP患者病情严重程度和死亡的预测能力。
入院时血清CYR61与病情严重程度及不良预后结果之间存在显著的正剂量反应关系，表明CYR61参与了CAP的病理生理过程。血清CYR61可能作为CAP患者诊断和预后的潜在生物标志物。
