TGF-β Blood Levels Distinguish Between Influenza A (H1N1)pdm09 Virus Sepsis and Sepsis due to Other Forms of Community-Acquired Pneumonia.
There is a strong interest in finding adequate biomarkers to aid in the diagnosis and prognosis of influenza A (H1N1)pdm09 virus infection. In this study, serum levels of inflammatory cytokines and laboratory markers were evaluated to assess their usefulness as biomarkers of influenza A (H1N1)pdm09 and their association with fatal cases. Serum samples of consecutive patients with a clinical presentation suggestive of influenza A (H1N1)pdm09 and progression to sepsis were evaluated. Serum inflammatory cytokines and routine laboratory tests were performed and correlated with positivity for influenza A (H1N1)pdm09 influenza by real time reverse transcription polymerase chain reaction and the results of three clinical severity scores (Sequential Organ Failure Assessment [SOFA], CURB-65, and Acute Physiology and Chronic Health Evaluation II [APACHE II]). High SOFA scores and some of its individual components, but not CURB-65 or APACHE II scores, correlate with fatal cases regardless of etiology. Total and unconjugated bilirubin, Ca(++), Cl(-), prothrombin times, and partial thromboplastin times discriminate influenza A (H1N1)pdm09 from other causes of community-acquired pneumonia. High levels of IL-8, IL-10, and IL-17 were increased in influenza A (H1N1)pdm09 patients when compared with controls (p<0.05). IL-6 levels were significantly elevated in influenza A (H1N1)pdm09 patients and non-(H1N1)pdm09 patients when compared with controls (p<0.05). TGF-β serum levels discern between healthy controls, influenza A (H1N1)pdm09 patients, and patients with other causes of community-acquired pneumonia. TGF-β levels were negatively correlated with SOFA on admission in influenza A (H1N1)pdm09 patients. TGF-β levels are a useful tool for differentiating influenza A (H1N1)pdm09 from other causes of pneumonia progressing to sepsis.
1Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.|2Department of Internal Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Erick J
EJ
Rendón-Ramirez
1Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.|2Department of Internal Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Alejandro
A
Ortiz-Stern
1Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.|2Department of Internal Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Corazon
C
Martinez-Mejia
1Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.|2Department of Internal Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Mario C
MC
Salinas-Carmona
3CIPTIR (Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias), Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Adrian
A
Rendon
4Centro de Investigaciones Biomédicas del Noreste del Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico.
Viviana L
VL
Mata-Tijerina
1Department of Immunology, Faculty of Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.|2Department of Internal Medicine, Universidad Autónoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Adrian G
AG
Rosas-Taraco
D000328:Adult; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D017714:Community-Acquired Infections / Q000097:blood* / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D007251:Influenza, Human / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D016753:Interleukin-10 / Q000097:blood; D020381:Interleukin-17 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D010314:Partial Thromboplastin Time; D011014:Pneumonia / Q000097:blood* / Q000382:microbiology / Q000821:virology; D011517:Prothrombin Time; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018805:Sepsis / Q000097:blood* / Q000382:microbiology / Q000821:virology; D012720:Severity of Illness Index; D016212:Transforming Growth Factor beta / Q000097:blood*
D015415:Biomarkers; C508606:CXCL8 protein, human; C508609:IL10 protein, human; C508600:IL6 protein, human; D020381:Interleukin-17; D015850:Interleukin-6; D016209:Interleukin-8; D016212:Transforming Growth Factor beta; D016753:Interleukin-10; D001663:Bilirubin