title: Contrasting inflammatory responses in severe and non-severe community-acquired pneumonia.
abstract: The objective of this study was to compare systemic and local cytokine profiles and neutrophil responses in patients with severe versus non-severe community-acquired pneumonia (CAP). Hospitalized patients with CAP were grouped according to the pneumonia severity index (PSI), as non-severe (PSI < 91 points) or severe (PSI ≥ 91 points). Blood and sputum samples were collected upon admission. Compared to non-severe CAP patients, the severe CAP group showed higher plasma levels of pro- and anti-inflammatory cytokines but in contrast, lower sputum concentrations of pro-inflammatory cytokines. Blood neutrophil functional responses were elevated in CAP patients compared to healthy controls. However, neutrophils from severe CAP patients showed reduced respiratory burst activity compared to the non-severe group. Results indicate that patients with severe CAP fail to mount a robust local pro-inflammatory response but exhibit instead a more substantial systemic inflammatory response, suggesting that a key driver of CAP severity may be the ability of the patient to generate an optimal local inflammatory response.
authors.affiliation: Department of Pathology & Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Fernandez-Botran
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Uriarte
authors.forename: Forest W
authors.initials: FW
authors.lastname: Arnold
authors.forename: Lisandra
authors.initials: L
authors.lastname: Rodriguez-Hernandez
authors.forename: Madhavi J
authors.initials: MJ
authors.lastname: Rane
authors.forename: Paula
authors.initials: P
authors.lastname: Peyrani
authors.forename: Timothy
authors.initials: T
authors.lastname: Wiemken
authors.forename: Robert
authors.initials: R
authors.lastname: Kelley
authors.forename: Srinivas
authors.initials: S
authors.lastname: Uppatla
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cavallazzi
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.forename: Letizia
authors.initials: L
authors.lastname: Morlacchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Aliberti
authors.forename: Colleen
authors.initials: C
authors.lastname: Jonsson
authors.forename: Julio A
authors.initials: JA
authors.lastname: Ramirez
authors.forename: Jose
authors.initials: J
authors.lastname: Bordon
mesh_terms: D000368:Aged; D017714:Community-Acquired Infections / Q000097:blood / Q000175:diagnosis*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D010343:Patient Admission; D011014:Pneumonia / Q000097:blood / Q000175:diagnosis*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013183:Sputum / Q000378:metabolism
chemical_list: D016207:Cytokines