title: Plasma levels of soluble intercellular adhesion molecule-1 as a biomarker for disease severity of patients with community-acquired pneumonia.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is characterized as an acute inflammation of the lung associated with the activation of macrophages and neutrophils. Intercellular adhesion molecule-1 (ICAM-1) is an essential adhesion molecule involved in immune cell recruitment in lung inflammation. We investigated whether ICAM-1 is a useful biomarker for assessing the disease severity of hospitalized adult patients with CAP.
  
  
  METHODS
  Plasma soluble ICAM-1 (sICAM-1) levels were measured in 78 patients with CAP and 69 healthy controls by using a commercial enzyme-linked immunosorbent assay. The pneumonia severity index scores were used to determine CAP severity in patients upon initial hospitalization.
  
  
  RESULTS
  The sICAM-1 and C-reactive protein (CRP) levels decreased significantly in patients with CAP after antibiotic treatment. The plasma concentration of sICAM-1 alone, but not CRP, was correlated with CAP severity according to the pneumonia severity index scores (r=0.431, p<0.001). The sICAM-1 levels in patients with CAP with high mortality risk were significantly higher than those in patients with CAP with medium or low mortality risk. Moreover, the sICAM-1 level showed a significant correlation with the length of hospital stay (r=0.488, p<0.001). Mechanistic investigations found that bacterial lipopolysaccharide induced upregulation of ICAM-1 expression through the c-Jun N-terminal kinase pathway in RAW264.7 macrophages.
  
  
  CONCLUSIONS
  Plasma sICAM-1 levels may play a role in the diagnosis and clinical assessment of CAP severity.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Senior Citizen Services, National Tainan Junior College of Nursing, Tainan, Taiwan.
authors.forename: Pin-Yu
authors.initials: PY
authors.lastname: Chang
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Chest, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Tsao
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jer-Hwa
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Graduate Institute of Clinical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Medical Education and Research, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ming-Hsien
authors.initials: MH
authors.lastname: Chien
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Wen-Yueh
authors.initials: WY
authors.lastname: Hung
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Pulmonary and Critical Care Unit, Changhua Hospital, Department of Health, Changhua, Taiwan. Electronic address: hiwen@chhw.mohw.gov.tw.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Huang
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan. Electronic address: ysf@csmu.edu.tw.
authors.forename: Shun-Fa
authors.initials: SF
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002460:Cell Line; D017714:Community-Acquired Infections / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood* / Q000378:metabolism; D007902:Length of Stay; D008070:Lipopolysaccharides / Q000494:pharmacology; D048670:MAP Kinase Kinase 4 / Q000378:metabolism; D008264:Macrophages / Q000187:drug effects / Q000378:metabolism; D008297:Male; D051379:Mice; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D018410:Pneumonia, Bacterial / Q000097:blood / Q000188:drug therapy; D011379:Prognosis
chemical_list: D015415:Biomarkers; D008070:Lipopolysaccharides; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D048670:MAP Kinase Kinase 4
keywords: Community-acquired pneumonia; ICAM-1; JNK pathway; LPS