Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China; Institute of Respiratory Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China.
School of Pharmacy, Drug Research & Development Center, Wannan Medical College, Wuhu, Anhui, 241002, China.
Respir Investig. 2023 Jan;61(1):84-94. doi: 10.1016/j.resinv.2022.09.007. Epub 2022 Nov 3.
Survivin is a member of apoptosis inhibitor proteins that evokes cellular proliferation and inhibits apoptosis. However, the role of survivin in community-acquired pneumonia (CAP) patients remains to be firmly established. The aim of this cohort study was to evaluate the correlations of serum survivin with the severity and prognosis of CAP patients.
This research included 470 eligible CAP patients. Serum fasting samples were drawn from patients, and serum survivin was measured by enzyme-linked immunosorbent assay (ELISA). Meanwhile, demographic characteristics and clinical information were collected. The prognosis of CAP patients was tracked.
Serum survivin gradually decreased with elevated CAP severity scores. Additionally, the correlative analysis suggested that serum survivin was associated with many clinical characteristics. Furthermore, mixed linear and logistic regression models indicated that serum survivin was negatively associated with severity. After adjusting for confounding factors, logistic regression analyses found that lower serum survivin on admission elevated the risks of mechanical ventilation, vasoactive agent usage, longer hospital stays, ICU admission, and even death during hospitalization. Serum survivin in combination with CAP severity scores elevated the predictive capacities for severity and death in CAP patients compared with a single indicator.
On admission, there are inverse dose-response associations of serum survivin with severity and poor prognosis in CAP patients, demonstrating that serum survivin may be involved in the pathophysiology process of CAP. Serum survivin may serve as a potential biomarker for disease evaluation and prognosis in CAP patients.
Survivin 是凋亡抑制蛋白家族的一员,它能引起细胞增殖并抑制细胞凋亡。然而,Survivin 在社区获得性肺炎(CAP)患者中的作用仍有待确定。本队列研究旨在评估血清 Survivin 与 CAP 患者严重程度和预后的相关性。
本研究纳入了 470 名符合条件的 CAP 患者。抽取患者空腹血清样本,采用酶联免疫吸附试验(ELISA)检测血清 Survivin。同时收集患者的人口统计学特征和临床信息,跟踪 CAP 患者的预后。
血清 Survivin 随 CAP 严重评分的升高而逐渐降低。相关性分析表明,血清 Survivin 与许多临床特征相关。此外,混合线性和逻辑回归模型表明,血清 Survivin 与严重程度呈负相关。调整混杂因素后,逻辑回归分析发现入院时血清 Survivin 降低会增加机械通气、血管活性药物使用、住院时间延长、入住 ICU 以及住院期间死亡的风险。与单一指标相比,血清 Survivin 联合 CAP 严重评分可提高 CAP 患者严重程度和死亡的预测能力。
入院时,血清 Survivin 与 CAP 患者的严重程度和不良预后呈负相关剂量反应关系,表明血清 Survivin 可能参与了 CAP 的病理生理过程。血清 Survivin 可能作为评估 CAP 患者疾病严重程度和预后的潜在生物标志物。