Inflammatory Markers of Lower Respiratory Tract Infection In Elderly People

Abstract

Bacterial infections of the respiratory tract are a major cause of morbidity and mortality in elderly people. The inflammatory response to such infection is an important protective process and has been suggested to be less effective in elderly patients. To investigate the inflammatory response in respiratory infections acquired in the community by elderly people we studied 52 consecutive patients who met the criteria for either a non-pneumonic chest infection or pneumonia. After exclusion, 41 patients were available for evaluation, with 25 fulfilling the criteria of pneumonia and 16 the criteria of chest infection. Pyrexia was a feature of the patients with pneumonia. Circulating levels of neutrophil elastase-alpha-1-antitrypsin complex and C-reactive protein were greater in the patients with pneumonia than in those with a chest infection and were reduced following antibiotic treatment. No changes occurred in the chest infection group for these markers of inflammation. In both groups, a further neutrophil granule protein, lactoferrin, was unaffected by antibiotic treatment. This study indicates that elderly patients with pneumonia can initiate an appropriate inflammatory response as demonstrated by clinical indicators and circulating mediators of the inflammatory response.

Extract from <i>Nandina domestica</i> Inhibits Lipopolysaccharide-Induced Cyclooxygenase-2 Expression in Human Pulmonary Epithelial A549 Cells

“…[2][3][4][5] Activation of these cells has been reported involved in a variety of respiratory disorders such as asthma, chronic obstructive pulmonary disease, cystic fibrosis and respiratory infections. 3,[6][7][8] Among chemical mediators released by epithelial cells, prostaglandins (PGs) play major roles in inflammatory processes of respiratory system 9) and are synthesized from arachidonic acid by a reaction catalyzed by cyclooxygenase (COX). Two major isoforms of COX have been identified: COX-1 is expressed constitutively in almost all tissues, and COX-2 is an inducible enzyme that is expressed in response to inflammatory cytokines or lipopolysaccharide (LPS), the major component of the outer membrane of all Gram-negative bacteria.…”

Evaluation of Acute-phase Reactants, Immunologic Markers and other Clinical and Laboratory Parameters in Patients with Pneumonia and Non-pneumonic Lower Respiratory Tract Infections

“…A few studies with varied sample sizes have analyzed the CRP levels in patients with pneumonia and OALRTI in children [34,35] , in adults [1,[36][37][38][39] and in the elderly [40] , all of which found higher levels of CRP in the former patients. Among the many clinical and laboratory parameters analyzed, we also found CRP to be the variable most tightly related to the diagnosis of pneumonia and the most useful parameter for the differentiation between these two conditions in the univariate, multivariate and ROC curve analyses.…”

“…Nevertheless, at least a certain discriminant value of CRP seems to be consistent across different prevalences of pneumonia, spectrum of ages and geographic settings and populations [1,[34][35][36][37][38][39][40] and consequently, CRP measurement may constitute a useful adjunct for the differentiation of pneumonia from OALRTI. In addition, the availability of rapid, reliable, cost-effective, near-patient tests for CRP [46,47] supports the routine use of this determination by general practitioners and emergency ward doctors.…”

Faktor–Faktor yang Berhubungan dengan Diagnosis Pneumonia pada Pasien Usia Lanjut

“…9 Penyakit komorbid lainnya yang dinilai memengaruhi pneumonia adalah keganasan, DM, penyakit paru kronik dan penyakit ginjal kronik. 21 Frekuensi penyakit komorbid pada pasien pneumonia usia lanjut sangat tinggi. Fry, dkk.…”

“…Pada penelitian ini, persentase penyakit-penyakit kronik seperti DM dapat memengaruhi kadar CRP. 21 Meer, dkk. 41 mengevaluasi keakuratan diagnostik CRP dalam mendeteksi pneumonia yang didagnosis secara radiologis.…”