Profiling inflammatory markers in patients with pneumonia on intensive care

Abstract

Clinical investigations lack predictive value when diagnosing pneumonia, especially when patients are ventilated and develop ventilator associated pneumonia (VAP). New tools to aid diagnosis are important to improve outcomes. This pilot study examines the potential for a panel of inflammatory mediators to aid in the diagnosis. Forty-four ventilated patients, 17 with pneumonia and 27 with brain injuries, eight of whom developed VAP, were recruited. 51 inflammatory mediators, including cytokines and oxylipins, were measured in patients’ serum using flow cytometry and mass spectrometry. The mediators could separate patients admitted to ICU with pneumonia compared to brain injury with an area under the receiver operating characteristic curve (AUROC) 0.75 (0.61–0.90). Changes in inflammatory mediators were similar in both groups over the course of ICU stay with 5,6-dihydroxyeicosatrienoic and 8,9-dihydroxyeicosatrienoic acids increasing over time and interleukin-6 decreasing. However, brain injured patients who developed VAP maintained inflammatory profiles similar to those at admission. A multivariate model containing 5,6-dihydroxyeicosatrienoic acid, 8,9-dihydroxyeicosatrienoic acid, intercellular adhesion molecule-1, interleukin-6, and interleukin-8, could differentiate patients with VAP from brain injured patients without infection (AUROC 0.94 (0.80–1.00)). The use of a selected group of markers showed promise to aid the diagnosis of VAP especially when combined with clinical data.

Research on Effects of Oropharyngeal Aspiration on Incidence of Ventilator-Associated Pneumonia in Patients with Cerebral Hemorrhage in ICU

“…When the individual is infected by bacterial invasion, the inflammatory factor is activated and its expression will be significantly increased and released into the blood, leading immune cells to identify and eliminate pathogens. The results of previous studies showed that, after ventilator-associated pneumonia, the systemic and local inflammatory responses were aggravated, and the levels of inflammatory factors, such as IL-6, IL-8, sTREM-1, PTX-3, and PCT, in serum increased significantly [ 27 ]. The serum immune factor level in the intervention group was lower than that, in the control group, which cannot confirm the causal relationship between the difference of inflammatory factors between two groups and the decrease of oropharyngeal pathogens entering the lower respiratory tract caused by oropharyngeal aspiration.…”

TPPU treatment of burned mice dampens inflammation and generation of bioactive DHET which impairs neutrophil function

“…The concept that oxylipins can modulate the behavior of immune cells in inflammatory diseases has evolved over the last decades 1 – 3 . Recently, clinical observational studies in inflammatory diseases and conditions such as sepsis, pneumonia, or surgical trauma assess oxylipin levels with the aim to establish health predictions and alter outcomes based on oxylipin dynamics 4 – 6 .…”

Extracting Explicable Rules for the Identification of Compound–Protein Interactions

“…Two GO terms (GO: 0034694 [response to prostaglandin] and GO: 0033240 [positive regulation of cellular amine metabolic process]) also enriched binding-associated interactions on the basis of the quantitative prediction parameters. Considering the detailed biological functions of these GO terms, effective CPIs like interactions between alanine and aspartate aminotransferase [56] and interactions between exogenous prostaglandin E2 and related receptors [57], [58] have been widely reported and validated in such two biological processes, validating the efficacy and accuracy of this rule. For the MACCS descriptors, a specific item named A117 was selected to describe the modified version of a nitrogenoxygen double bond for detailed discussion [59] and analysis.…”