TY - JOUR
T1 - YKL-40, CCL18 and SP-D predict mortality in patients hospitalized with community-acquired pneumonia
AU - Spoorenberg, Simone M C
AU - Vestjens, Stefan M T
AU - Rijkers, Ger T.
AU - Meek, Bob
AU - van Moorsel, Coline H M
AU - Grutters, Jan C
AU - Bos, Willem Jan W
AU - Biesma, Douwe H.
AU - Endeman, Henrik
AU - van de Garde, Ewoudt M W
AU - Hardeman, Hans
AU - Heijligenberg, Rik
AU - Meijvis, Sabine C A
AU - Remmelts, Hilde H.F.
AU - van Velzen-Blad, Heleen
AU - Voorn, Paul G P
AU - Ovidius Study Group
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background and objective: The aim of this study was to investigate the prognostic value of four biomarkers, YKL-40, chemokine (C-C motif) ligand 18 (CCL18), surfactant protein-D (SP-D) and CA 15-3, in patients admitted with community-acquired pneumonia (CAP). These markers have been studied extensively in chronic pulmonary disease, but in acute pulmonary disease their prognostic value is unknown. Methods: A total of 289 adult patients who were hospitalized with CAP and participated in a randomized controlled trial were enrolled. Biomarker levels were measured on the day of admission. Intensive care unit admission, 30-day, 1-year and long-term mortality (median follow-up of 5.4 years, interquartile range (IQR): 4.7–6.1) were recorded as outcomes. Results: Median YKL-40 and CCL18 levels were significantly higher and levels of SP-D were significantly lower in CAP patients compared to healthy controls. Significantly higher YKL-40, CCL18 and SP-D levels were found in patients classified in pneumonia severity index classes 4–5 and with a CURB-65 score ≥2 compared to patients with less severe pneumonia. Furthermore, these three markers were significant predictors for long-term mortality in multivariate analysis and compared with C-reactive protein and procalcitonin level on admission, area under the curves were higher for 30-day, 1-year and long-term mortality. CA 15-3 levels were less predictive. Conclusion: YKL-40, CCL18 and SP-D levels were higher in patients with more severe pneumonia, possibly reflecting the extent of pulmonary inflammation. Of these, YKL-40 most significantly predicts mortality for CAP.
AB - Background and objective: The aim of this study was to investigate the prognostic value of four biomarkers, YKL-40, chemokine (C-C motif) ligand 18 (CCL18), surfactant protein-D (SP-D) and CA 15-3, in patients admitted with community-acquired pneumonia (CAP). These markers have been studied extensively in chronic pulmonary disease, but in acute pulmonary disease their prognostic value is unknown. Methods: A total of 289 adult patients who were hospitalized with CAP and participated in a randomized controlled trial were enrolled. Biomarker levels were measured on the day of admission. Intensive care unit admission, 30-day, 1-year and long-term mortality (median follow-up of 5.4 years, interquartile range (IQR): 4.7–6.1) were recorded as outcomes. Results: Median YKL-40 and CCL18 levels were significantly higher and levels of SP-D were significantly lower in CAP patients compared to healthy controls. Significantly higher YKL-40, CCL18 and SP-D levels were found in patients classified in pneumonia severity index classes 4–5 and with a CURB-65 score ≥2 compared to patients with less severe pneumonia. Furthermore, these three markers were significant predictors for long-term mortality in multivariate analysis and compared with C-reactive protein and procalcitonin level on admission, area under the curves were higher for 30-day, 1-year and long-term mortality. CA 15-3 levels were less predictive. Conclusion: YKL-40, CCL18 and SP-D levels were higher in patients with more severe pneumonia, possibly reflecting the extent of pulmonary inflammation. Of these, YKL-40 most significantly predicts mortality for CAP.
KW - biomarkers
KW - chemokine (C-C motif) ligand 18 protein, human
KW - mortality
KW - pneumonia
KW - YKL-40 protein, human
UR - http://www.scopus.com/inward/record.url?scp=85000399540&partnerID=8YFLogxK
U2 - 10.1111/resp.12924
DO - 10.1111/resp.12924
M3 - Article
AN - SCOPUS:85000399540
SN - 1323-7799
VL - 22
SP - 542
EP - 550
JO - Respirology
JF - Respirology
IS - 3
ER -