Wollner Gregor, Hruska Florian, Ettel Paul, Weichhart Thomas, Koenig Felix R M, Negrin Lukas L
Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, 1090, Vienna, Austria.
Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
Lung. 2025 Mar 13;203(1):44. doi: 10.1007/s00408-025-00799-2.
Pneumonia is one of the most common complications in patients suffering multiple traumas and is associated with an exceptionally high mortality rate. MIP-3-alpha and MIP-3-beta are pro-inflammatory chemokines expressed in the pulmonary mucosa and are reported to play a crucial role in inflammation. Thus, the present study aimed to investigate whether there is an association between MIP-3-alpha- and MIP-3-beta expression and manifestation of pneumonia in patients suffering polytrauma.
This prospective outcome study was conducted at our level I trauma center, and 110 polytraumatized patients (Injury Severity Score ≥ 16, ≥ 2 body regions) were prospectively enrolled (median age, 39 years; median Injury Severity Score (ISS), 33; 70.9% male) over four years. Protein levels were assessed at admission (day 0) and subsequently on days 1, 3, 5, 7, and 10 during routine blood draws, utilizing one separation gel tube for each measurement. Furthermore, the correlation between MIP-3-alpha- and MIP-3-beta expression and the manifestation of pneumonia was calculated.
We observed significantly higher levels of MIP-3-beta expression over the entire time course in the pneumonia cohort. MIP-3-alpha levels were elevated on days 3, 5, 7, and 10 post-trauma in patients suffering from pneumonia. In contrast, no comparable pattern was observed for other pro- and anti-inflammatory cytokines (e.g., IL-6 or TNF-alpha). A peak of serum level expression was documented on day 5 in both biomarkers (MIP-3-alpha 51.8 pg/mL; MIP-3-beta 328.0 pg/mL). ROC analysis provided a cut-off value of 19.3 pg/mL (sensitivity 0.87, specificity 0.33; AUC 0.757) for MIP-3-alpha, whereas a cut-off value of 209.5 pg/mL (sensitivity 0.78, specificity 0.34; AUC 0.757) was determined for MIP-3-beta on day 5.
The present study demonstrated elevated MIP-3-alpha and MIP-3-beta levels as sensitive pneumonia predictors in patients with multiple traumas. These biomarkers allow for identifying patients at high risk of developing pneumonia at an early stage.
肺炎是多发伤患者最常见的并发症之一，死亡率极高。巨噬细胞炎性蛋白-3α（MIP-3-α）和巨噬细胞炎性蛋白-3β（MIP-3-β）是在肺黏膜中表达的促炎趋化因子，据报道在炎症中起关键作用。因此，本研究旨在探讨多发伤患者中MIP-3-α和MIP-3-β的表达与肺炎表现之间是否存在关联。
本前瞻性结局研究在我们的一级创伤中心进行，前瞻性纳入了110例多发伤患者（损伤严重度评分≥16，≥2个身体部位），为期四年（中位年龄39岁；中位损伤严重度评分（ISS）33；70.9%为男性）。在入院时（第0天）以及随后在第1、3、5、7和10天常规采血时评估蛋白水平，每次测量使用一支分离胶管。此外，计算了MIP-3-α和MIP-3-β表达与肺炎表现之间的相关性。
我们观察到肺炎队列在整个时间过程中MIP-3-β表达水平显著更高。肺炎患者创伤后第3、5、7和10天MIP-3-α水平升高。相比之下，其他促炎和抗炎细胞因子（如IL-6或TNF-α）未观察到类似模式。两种生物标志物（MIP-3-α 51.8 pg/mL；MIP-3-β 328.0 pg/mL）在第5天均记录到血清水平表达峰值。MIP-3-α的ROC分析得出第5天的截断值为19.3 pg/mL（敏感性0.87，特异性0.33；AUC 0.757），而MIP-3-β的截断值为209.5 pg/mL（敏感性0.78，特异性0.34；AUC 0.7 TRIPs协定中的国民待遇原则要求成员在知识产权保护方面，给予其他成员的国民不低于本国国民的待遇。然而，该原则也存在一些例外情况。例如，在司法和行政程序方面，成员可以规定某些程序只适用于本国国民，而不适用于其他成员的国民。此外，成员还可以根据公共利益的需要，对知识产权的保护进行合理的限制，这些限制可能会导致对其他成员国民的待遇低于本国国民。
本研究表明，MIP-3-α和MIP-3-β水平升高是多发伤患者肺炎的敏感预测指标。这些生物标志物有助于早期识别有发生肺炎高风险的患者。 57）。
本研究表明，多发伤患者中MIP-3-α和MIP-3-β水平升高是肺炎的敏感预测指标。这些生物标志物有助于早期识别有发生肺炎高风险的患者。
