Hospital-acquired pneumonia after lung resection surgery is associated with characteristic cytokine gene expression.
Authors
White, MaryMartin-Loeches, Ignacio
Lawless, Matthew W
O'Dwyer, Michael J
Doherty, Derek G
Young, Vincent
Kelleher, Dermot
McManus, Ross
Ryan, Thomas
Affiliation
Department of Anaesthesia and Critical Care Medicine, St. James Hospital, and, Deparmtent of Clinical Medicine, Trinity College Dublin, Dublin 8, Ireland., drmbwhite@yahoo.co.ukIssue Date
2012-02-01T10:44:31ZMeSH
AgedAlgorithms
Biological Markers/metabolism
Cross Infection/*epidemiology/metabolism
Cytokines/*genetics/metabolism
Disease Susceptibility
Female
Gene Expression Regulation/*physiology
Humans
Interferon-gamma/genetics/metabolism
Interleukin-23/genetics/metabolism
Interleukin-6/genetics/metabolism
Lung/*physiopathology/*surgery
Male
Middle Aged
Pneumonia/*epidemiology/metabolism
Postoperative Complications/*epidemiology/metabolism
Prevalence
Prospective Studies
RNA, Messenger/metabolism
Retrospective Studies
Tumor Necrosis Factor-alpha/genetics/metabolism
Metadata
Show full item recordCitation
Chest. 2011 Mar;139(3):626-32. Epub 2010 Sep 9.Journal
ChestDOI
10.1378/chest.10-0016PubMed ID
20829336Abstract
BACKGROUND: Infection in humans has been linked with altered cytokine gene transcription. It is unclear whether this phenomenon is a consequence of an established disease process or precedes the infective process. The primary end point of this study was to determine whether hospital-acquired pneumonia (HAP) was associated with differential gene expression of interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and IL-23p19. The secondary end point was to identify whether alteration in gene expression preceded the clinical onset of infection. METHODS: Sixty consecutive patients undergoing elective thoracic surgery were recruited. HAP was diagnosed as per National Nosocomial Infection Surveillance guidelines. Messenger RNA (mRNA) and protein levels were analyzed preoperatively and 24 h and 5 days postoperatively. RESULTS: Forty-one patients had an uncomplicated recovery. Nineteen patients developed HAP. IL-6, IL-10, IL-12p35, IL-23p19, IL-27p28, TNF-alpha, and IFN-gamma mRNA and protein levels of IL-6, IL-23, and IFN-gamma in peripheral blood leukocytes were analyzed before surgery and 24 h and 5 days postsurgery. IL-23p19 mRNA levels were reduced in the pneumonia group (median, 4.19; 10th-90th centile range, 3.90-4.71) compared with the nonpneumonia group (4.50; 3.85-5.32) day 1 postsurgery (P=02). IFN-gamma mRNA levels were reduced in the pneumonia group (2.48; 1.20-3.20) compared with nonpneumonia group (2.81; 2.10-3.26) (P=03) day 5 postsurgery. Results are expressed as log to base 10 copy numbers of cytokine mRNA per 10 million beta-actin mRNA copy numbers. All values are given as median and 10th to 90th centile range. CONCLUSIONS: Cytokine gene expression is altered immediately following surgery in patients with postoperative HAP.Language
engISSN
1931-3543 (Electronic)0012-3692 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1378/chest.10-0016
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