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    Hospital-acquired pneumonia after lung resection surgery is associated with characteristic cytokine gene expression.

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    Authors
    White, Mary
    Martin-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.uk
    Issue Date
    2012-02-01T10:44:31Z
    MeSH
    Aged
    Algorithms
    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
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    Citation
    Chest. 2011 Mar;139(3):626-32. Epub 2010 Sep 9.
    Journal
    Chest
    URI
    http://hdl.handle.net/10147/207781
    DOI
    10.1378/chest.10-0016
    PubMed ID
    20829336
    Abstract
    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
    eng
    ISSN
    1931-3543 (Electronic)
    0012-3692 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1378/chest.10-0016
    Scopus Count
    Collections
    St. James's Hospital

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