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Soluble endothelial selectin in acute lung injury complicated by severe pneumonia.

Osaka D, Shibata Y, Kanouchi K, Nishiwaki M, Kimura T, Kishi H, Abe S, Inoue S, Tokairin Y, Igarashi A, Yamauchi K, Aida Y, Nemoto T, Nunomiya K, Fukuzaki K, Kubota I - Int J Med Sci (2011)

Bottom Line: Among these patients, six had ALI or a condition that was clinically comparable to ALI (cALI).All patients who were enrolled were successfully treated and survived.Univariate and multivariate logistic regression analyses showed that sES was the only significant factor for identifying complicating ALI/cALI, independently of C-reactive protein (CRP) and lactate dehydrogenase (LDH).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.

ABSTRACT

Background: Pneumonia is still one of the most frequent causes of death in the elderly. Complication of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) by pneumonia makes patients very ill due to severe respiratory failure. Biomarkers that can discriminate the presence of complicating ALI/ARDS are required for early detection. The aim of this research was to investigate whether soluble endothelial selectin (sES) could be a biomarker for ALI.

Methods: Serum sES levels were measured in 27 pneumonia patients, who were enrolled between April 2006 and September 2007. Among these patients, six had ALI or a condition that was clinically comparable to ALI (cALI). All patients who were enrolled were successfully treated and survived.

Results: Circulating sES levels were elevated in pneumonia patients with ALI/cALI, and sES levels decreased following treatment of their pneumonia. Univariate and multivariate logistic regression analyses showed that sES was the only significant factor for identifying complicating ALI/cALI, independently of C-reactive protein (CRP) and lactate dehydrogenase (LDH). By receiver operating characteristic (ROC) curve analysis, the cut-off value for sES was 40.1 ng/mL, with a sensitivity of 0.8 and a specificity of 0.8.

Conclusion: sES may be a useful biomarker for discriminating complicating ALI/cALI in patients with severe pneumonia.

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Related in: MedlinePlus

Time courses of soluble endothelial selectin, C-reactive protein and lactate dehydrogenase after commencement of treatment for pneumonia, according to complicating acute lung injury. The time courses of soluble endothelial selectin (sES, A), C-reactive protein (CRP, B) and lactate dehydrogenase (LDH, C) are shown according to complicating acute lung injury (ALI)/clinical status comparable to ALI (cALI). sES levels were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. sES levels decreased after commencement of treatment in the ALI/cALI group (P = 0.017). However, sES levels in the non-ALI/cALI group were not significantly different at each time point (P = 0.075). CRP levels in pneumonia patients with ALI/cALI tended to be higher than those in patients without ALI/cALI, although the difference was not statistically significant. CRP levels decreased after treatment in the non-ALI/cALI group (P = 0.008). However, in the ALI/cALI group, the differences in CRP levels at each time point did not reach statistical significance (P = 0.07). LDH levels on Day 1, Days 3-4, and Days 5-6 were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. However, the differences in LDH levels at each time point were not statistically significant either in the ALI/cALI group or in the non-ALI/cALI group (P = 0.444 and P = 0.527, respectively). * P < 0.05 compared with Day1; # P < 0.05 compared with the ALI/cALI group
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Figure 1: Time courses of soluble endothelial selectin, C-reactive protein and lactate dehydrogenase after commencement of treatment for pneumonia, according to complicating acute lung injury. The time courses of soluble endothelial selectin (sES, A), C-reactive protein (CRP, B) and lactate dehydrogenase (LDH, C) are shown according to complicating acute lung injury (ALI)/clinical status comparable to ALI (cALI). sES levels were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. sES levels decreased after commencement of treatment in the ALI/cALI group (P = 0.017). However, sES levels in the non-ALI/cALI group were not significantly different at each time point (P = 0.075). CRP levels in pneumonia patients with ALI/cALI tended to be higher than those in patients without ALI/cALI, although the difference was not statistically significant. CRP levels decreased after treatment in the non-ALI/cALI group (P = 0.008). However, in the ALI/cALI group, the differences in CRP levels at each time point did not reach statistical significance (P = 0.07). LDH levels on Day 1, Days 3-4, and Days 5-6 were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. However, the differences in LDH levels at each time point were not statistically significant either in the ALI/cALI group or in the non-ALI/cALI group (P = 0.444 and P = 0.527, respectively). * P < 0.05 compared with Day1; # P < 0.05 compared with the ALI/cALI group

Mentions: The time courses for sES, CRP and LDH according to complicating ALI/cALI are shown in Figure 1. sES levels were higher in pneumonia patients with ALI/cALI than in those patients without ALI/cALI. sES levels decreased after commencement of treatment in the ALI/cALI group (P = 0.017). However, in the non-ALI/cALI group sES levels did not differ significantly at each time point (P = 0.075). CRP levels in pneumonia patients with ALI/cALI tended to be higher than those in patients without ALI/cALI, although the difference was not statistically significant. CRP levels decreased after the commencement of treatment in the non-ALI/cALI group (P = 0.008). However, in the ALI/cALI group, the differences in CRP levels at each time point did not reach statistical significance (P = 0.07). LDH levels on day 1, days 3-4, and days 5-6 were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. However, the differences in LDH levels at each time point were not statistically significant either in the ALI/cALI group or in the non-ALI/cALI group (P = 0.444 and P = 0.527, respectively).


Soluble endothelial selectin in acute lung injury complicated by severe pneumonia.

Osaka D, Shibata Y, Kanouchi K, Nishiwaki M, Kimura T, Kishi H, Abe S, Inoue S, Tokairin Y, Igarashi A, Yamauchi K, Aida Y, Nemoto T, Nunomiya K, Fukuzaki K, Kubota I - Int J Med Sci (2011)

Time courses of soluble endothelial selectin, C-reactive protein and lactate dehydrogenase after commencement of treatment for pneumonia, according to complicating acute lung injury. The time courses of soluble endothelial selectin (sES, A), C-reactive protein (CRP, B) and lactate dehydrogenase (LDH, C) are shown according to complicating acute lung injury (ALI)/clinical status comparable to ALI (cALI). sES levels were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. sES levels decreased after commencement of treatment in the ALI/cALI group (P = 0.017). However, sES levels in the non-ALI/cALI group were not significantly different at each time point (P = 0.075). CRP levels in pneumonia patients with ALI/cALI tended to be higher than those in patients without ALI/cALI, although the difference was not statistically significant. CRP levels decreased after treatment in the non-ALI/cALI group (P = 0.008). However, in the ALI/cALI group, the differences in CRP levels at each time point did not reach statistical significance (P = 0.07). LDH levels on Day 1, Days 3-4, and Days 5-6 were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. However, the differences in LDH levels at each time point were not statistically significant either in the ALI/cALI group or in the non-ALI/cALI group (P = 0.444 and P = 0.527, respectively). * P < 0.05 compared with Day1; # P < 0.05 compared with the ALI/cALI group
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3100737&req=5

Figure 1: Time courses of soluble endothelial selectin, C-reactive protein and lactate dehydrogenase after commencement of treatment for pneumonia, according to complicating acute lung injury. The time courses of soluble endothelial selectin (sES, A), C-reactive protein (CRP, B) and lactate dehydrogenase (LDH, C) are shown according to complicating acute lung injury (ALI)/clinical status comparable to ALI (cALI). sES levels were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. sES levels decreased after commencement of treatment in the ALI/cALI group (P = 0.017). However, sES levels in the non-ALI/cALI group were not significantly different at each time point (P = 0.075). CRP levels in pneumonia patients with ALI/cALI tended to be higher than those in patients without ALI/cALI, although the difference was not statistically significant. CRP levels decreased after treatment in the non-ALI/cALI group (P = 0.008). However, in the ALI/cALI group, the differences in CRP levels at each time point did not reach statistical significance (P = 0.07). LDH levels on Day 1, Days 3-4, and Days 5-6 were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. However, the differences in LDH levels at each time point were not statistically significant either in the ALI/cALI group or in the non-ALI/cALI group (P = 0.444 and P = 0.527, respectively). * P < 0.05 compared with Day1; # P < 0.05 compared with the ALI/cALI group
Mentions: The time courses for sES, CRP and LDH according to complicating ALI/cALI are shown in Figure 1. sES levels were higher in pneumonia patients with ALI/cALI than in those patients without ALI/cALI. sES levels decreased after commencement of treatment in the ALI/cALI group (P = 0.017). However, in the non-ALI/cALI group sES levels did not differ significantly at each time point (P = 0.075). CRP levels in pneumonia patients with ALI/cALI tended to be higher than those in patients without ALI/cALI, although the difference was not statistically significant. CRP levels decreased after the commencement of treatment in the non-ALI/cALI group (P = 0.008). However, in the ALI/cALI group, the differences in CRP levels at each time point did not reach statistical significance (P = 0.07). LDH levels on day 1, days 3-4, and days 5-6 were higher in pneumonia patients with ALI/cALI than in those without ALI/cALI. However, the differences in LDH levels at each time point were not statistically significant either in the ALI/cALI group or in the non-ALI/cALI group (P = 0.444 and P = 0.527, respectively).

Bottom Line: Among these patients, six had ALI or a condition that was clinically comparable to ALI (cALI).All patients who were enrolled were successfully treated and survived.Univariate and multivariate logistic regression analyses showed that sES was the only significant factor for identifying complicating ALI/cALI, independently of C-reactive protein (CRP) and lactate dehydrogenase (LDH).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.

ABSTRACT

Background: Pneumonia is still one of the most frequent causes of death in the elderly. Complication of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) by pneumonia makes patients very ill due to severe respiratory failure. Biomarkers that can discriminate the presence of complicating ALI/ARDS are required for early detection. The aim of this research was to investigate whether soluble endothelial selectin (sES) could be a biomarker for ALI.

Methods: Serum sES levels were measured in 27 pneumonia patients, who were enrolled between April 2006 and September 2007. Among these patients, six had ALI or a condition that was clinically comparable to ALI (cALI). All patients who were enrolled were successfully treated and survived.

Results: Circulating sES levels were elevated in pneumonia patients with ALI/cALI, and sES levels decreased following treatment of their pneumonia. Univariate and multivariate logistic regression analyses showed that sES was the only significant factor for identifying complicating ALI/cALI, independently of C-reactive protein (CRP) and lactate dehydrogenase (LDH). By receiver operating characteristic (ROC) curve analysis, the cut-off value for sES was 40.1 ng/mL, with a sensitivity of 0.8 and a specificity of 0.8.

Conclusion: sES may be a useful biomarker for discriminating complicating ALI/cALI in patients with severe pneumonia.

Show MeSH
Related in: MedlinePlus