help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on September 15, 2005, doi:10.1164/rccm.200506-888OC

Am. J. Respir. Crit. Care Med., Volume 172, Number 11, December 2005, 1440-1446

A more recent version of this article appeared on December 1, 2005
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200506-888OCv1
172/11/1440    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yende, S.
Right arrow Articles by Kritchevsky, S. B
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yende, S.
Right arrow Articles by Kritchevsky, S. B

Submitted on June 8, 2005
Accepted on September 13, 2005

Pre-Infection Systemic Inflammatory Markers and Risk of Hospitalization due to Pneumonia

Sachin Yende1*, Elaine I Tuomanen2, Richard G Wunderink3, Alka Kanaya4, Anne B Newman5, Tamara Harris6, Nathalie de Rekeneire7, and Stephen B Kritchevsky8

1 Department of Critical Care Medicine, The University of Pittsburgh, CRISMA Laboratory, Pittsburgh, PA, USA, 2 Department of Infectious Diseases, St. Jude's Children's Research Hospital, Memphis, TN, USA, 3 Division of Pulmonary and Critical Care Medicine, Northwestern University, Chicago, IL, USA, 4 Division of General Internal Medicine, University of California, San Francisco, CA, USA, 5 Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA, 6 National Institute of Aging, Bethesda, MD, USA, 7 Laboratory of Epidemiology, Demography and Biometry, National Institute of Aging, Bethesda, MD, USA, 8 Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC, USA

* To whom correspondence should be addressed. E-mail: yendes{at}upmc.edu.

Rationale: Elevated pro-inflammatory cytokines are associated with severity of pneumonia, but the role of pre-infection cytokine levels in the predisposition to pneumonia in humans is less clear. Objective: To ascertain role of pre-infection inflammatory markers on susceptibility to Community-acquired pneumonia(CAP). Methods: Longitudinal analysis over 6.5 years of a cohort that consists of 70-79 year well-functioning elderly. Measurements: Association between pre-infection tumor necrosis factor (TNF), interleukin-6 (IL-6), and C-reactive protein (CRP) levels and CAP requiring hospitalization. Results: Of the 3075 participants, 161 (5.2%) developed at least one episode of CAP requiring hospitalization over a median duration of 3.3 years. The highest tertiles of TNF (>3.7pg/ml) and IL-6 (>2.4pg/ml) were associated with increased risk of CAP, and the adjusted odds ratios were 1.6 (95% confidence interval [CI]=1.02-2.7) and 1.7(95% CI=1.1-2.8), respectively. The adjusted risk of CAP with at least one of these markers in the highest tertile was 1.6 (95%CI=1.1-2.3). TNF and IL-6 levels in the highest tertile had a synergistic effect (P=0.01 for interaction), and risk of CAP for both markers in the highest tertile was 2.8 (95%CI=1.8-4.3). A FEV1≤50% of predicted was associated with the highest risk of CAP (adjusted odds ratio=3.6, 95%CI=2.3-5.6). Furthermore,TNF and IL-6 levels modified risk of CAP in participants with co-existing medical conditions and history of smoking. Conclusion: In the well-functioning elderly pre-infection systemic levels of TNF and IL-6 were associated with higher risk of CAP requiring hospitalization in smokers and those with co-existing medical conditions.
Key words: Pneumonia, inflammatory markers, tumor necrosis factor, interleukin-6




This article has been cited by other articles:


Home page
 ThoraxHome page
J-Q He, M G Foreman, K Shumansky, X Zhang, L Akhabir, D D Sin, S F P Man, D L DeMeo, A A Litonjua, E K Silverman, et al.
Associations of IL6 polymorphisms with lung function decline and COPD
Thorax, August 1, 2009; 64(8): 698 - 704.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Yende, G. D'Angelo, J. A. Kellum, L. Weissfeld, J. Fine, R. D. Welch, L. Kong, M. Carter, D. C. Angus, and for the GenIMS Investigators
Inflammatory Markers at Hospital Discharge Predict Subsequent Mortality after Pneumonia and Sepsis
Am. J. Respir. Crit. Care Med., June 1, 2008; 177(11): 1242 - 1247.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Yende, D. C. Angus, J. Ding, A. B. Newman, J. A. Kellum, R. Li, R. E. Ferrell, J. Zmuda, S. B. Kritchevsky, T. B. Harris, et al.
4G/5G Plasminogen Activator Inhibitor-1 Polymorphisms and Haplotypes Are Associated with Pneumonia
Am. J. Respir. Crit. Care Med., December 1, 2007; 176(11): 1129 - 1137.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. P. Espana, A. Capelastegui, I. Gorordo, C. Esteban, M. Oribe, M. Ortega, A. Bilbao, and J. M. Quintana
Development and Validation of a Clinical Prediction Rule for Severe Community-acquired Pneumonia
Am. J. Respir. Crit. Care Med., December 1, 2006; 174(11): 1249 - 1256.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
G. P. Anderson
COPD, asthma and C-reactive protein.
Eur. Respir. J., May 1, 2006; 27(5): 874 - 876.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. B. Milbrandt, A. Ishizaka, and D. C. Angus
Update in critical care 2005.
Am. J. Respir. Crit. Care Med., April 15, 2006; 173(8): 833 - 841.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2005 American Thoracic Society 		  Membership Renewal