title: Is NOX2 upregulation implicated in myocardial injury in patients with pneumonia?
abstract: In the present study, we tested the hypothesis that oxidative stress could be implicated in myocardial damage during the acute phase of pneumonia. NOX2 activation, the catalytic subunit of NADPH oxidase, and high-sensitivity cardiac troponin T (hs-cTnT) elevation have been analyzed in two hundred forty-eight consecutive patients hospitalized for community-acquired pneumonia. Serum NOX2-derived peptide (sNOX2-dp), a marker of NOX2 activation, and 8-isoprostaglandin F2α (8-iso-PGF2α), a marker of oxidative stress, were measured upon admission; serum hs-cTnT and ECG were measured every 12 and 24 h, respectively. One hundred thirty-five patients (54%) showed elevated serum levels of hs-cTnT (>0.014 μg/L). A logistic regression analysis showed sNOX2-dp (p<0.001), Pneumonia Severity Index score (p<0.001), renal failure (p=0.024), and ejection fraction (p<0.001) as independent predictors of elevated serum levels of hs-cTnT. Serum sNOX2-dp was linearly correlated with hs-cTnT (Rs=0.538; p<0.001) and 8-iso-PGF2α (Rs=0.354; p<0.001). The study provides the first evidence of a significant association between serum cardiac Troponin T elevation and NOX2 upregulation in patients with pneumonia. This finding raises the hypothesis that NOX2-derived oxidative stress may be implicated in myocardial injury and that its inhibition could be a novel therapeutic strategy to limit it.
authors: 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome, Italy .
authors: Roberto
authors: R
authors: Cangemi
authors: Camilla
authors: C
authors: Calvieri
authors: Tommaso
authors: T
authors: Bucci
authors: Roberto
authors: R
authors: Carnevale
authors: Marco
authors: M
authors: Casciaro
authors: Elisabetta
authors: E
authors: Rossi
authors: Cinzia Myriam
authors: CM
authors: Calabrese
authors: Gloria
authors: G
authors: Taliani
authors: Stefania
authors: S
authors: Grieco
authors: Marco
authors: M
authors: Falcone
authors: Paolo
authors: P
authors: Palange
authors: Giuliano
authors: G
authors: Bertazzoni
authors: Andrea
authors: A
authors: Celestini
authors: Pasquale
authors: P
authors: Pignatelli
authors: Francesco
authors: F
authors: Violi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D017714:Community-Acquired Infections; D015237:Dinoprost / Q000031:analogs & derivatives / Q000378:metabolism; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology* / Q000209:etiology / Q000378:metabolism; D017202:Myocardial Ischemia / Q000201:enzymology / Q000209:etiology / Q000378:metabolism; D009206:Myocardium / Q000201:enzymology* / Q000378:metabolism; D000074662:NADPH Oxidase 2; D019255:NADPH Oxidases / Q000378:metabolism*; D016017:Odds Ratio; D018384:Oxidative Stress; D011014:Pneumonia / Q000150:complications / Q000201:enzymology* / Q000378:metabolism; D017382:Reactive Oxygen Species; D012720:Severity of Illness Index; D020107:Troponin T / Q000378:metabolism*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D008562:Membrane Glycoproteins; D017382:Reactive Oxygen Species; D020107:Troponin T; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost; C056558:CYBB protein, human; D000074662:NADPH Oxidase 2; D019255:NADPH Oxidases