Perfil de biomarcadores inflamatórios dos pacientes com pneumonia de um hospital no alto sertão paraibano / Profile of inflammatory biomarkers of patients with pneumonia in a hospital in the upper sertão of Paraíba
DOI:
https://doi.org/10.14295/idonline.v15i57.3202Palavras-chave:
Creatinina. Fator de Necrose Tumoral Alfa. Interleucina-6. Pneumonia. Proteína C-reativa.Resumo
Objetivo: Avaliar alterações no perfil de biomarcadores (proteína C reativa, fator de necrose tumoral, interleucina 6 e creatinina) em pacientes com pneumonia, durante o período de internação segundo a sobrevivência ou óbito, relacionando a gravidade do quadro de pneumonia ou indicativo de desenvolvimento de doença renal aguda em pacientes com pneumonia. Método: Foi realizado um estudo prospectivo com 47 pacientes que foram internados com pneumonia, no município de Cajazeiras, PB. Foram realizadas análises laboratoriais para quantificação sérica de creatinina, proteína C reativa, IL-6 e TNF- α. Resultados: Foram analisados segundo o teste de Mann-Whitney e o teste de correlação de Spearman. Foram consideradas diferenças significativas quando p<0,05. Observou-se que os níveis de creatinina, proteína C reativa, IL-6 e TNF-α estavam mais elevados no grupo dos pacientes com pneumonia que vieram a óbito. Os pacientes com pneumonia e doença renal aguda, do grupo que foram a óbito apresentaram maiores níveis de creatinina e IL-6. Para esse o grupo, os níveis de creatinina, TNF-α e IL-6 apresentaram correlação diretamente proporcionais ao escore da escala de CURB-65. Conclusão: Sugere-se que biomarcadores inflamatórios podem ser utilizados no monitoramento de agravo no quadro clínico da doença.
Palavras-chave: Creatinina. Fator de Necrose Tumoral Alfa. Interleucina-6. Pneumonia. Proteína C-reativa.
Abstract: The aim of this study was to evaluate changes in the profile of biomarkers (C-reactive protein, tumor necrosis factor, interleukin 6 and creatinine) in patients with pneumonia, during the hospitalization period, according to survival or death, relating the severity of pneumonia or indicative of development of acute kidney disease in patients with pneumonia. A prospective study was carried out with 47 patients who were hospitalized with pneumonia in the city of Cajazeiras, Paraíba. Laboratory analyzes were performed to quantify serum creatinine, C-reactive protein, IL-6 and TNF-α. Results were analyzed using the Mann-Whitney test and the Spearman correlation test. Significant differences were considered when p<0.05. It was observed that the levels of creatinine, C-reactive protein, IL-6 and TNF-α were higher in the group of patients with pneumonia who died. Patients with pneumonia and acute kidney disease from the group who died had higher levels of creatinine and IL-6. For this group, creatinine, TNF-α and IL-6 levels correlated directly proportional to the CURB-65 scale score. It is suggested that inflammatory biomarkers can be used to monitor the disease's clinical condition.
Keywords: Creatinine. Tumor Necrosis Factor Alpha. Interleukin-6. Pneumonia. C-reactive protein.
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Referências
WORLD HEALTH ORGANIZATION. 2014. Pandemic and epidemic diseases. Infection prevention and control of epidemic and pandemic-prone acute respiratory infections. [internet]. Geneva; 2014 [acesso em 10 dez 2019]. Disponível em: http://apps.who.int/iris/bitstream/10665/112656/1/9789241507134_ eng.pdf?ua.
VANONI NM et al.. Management of acute respiratory failure due to community-acquired pneumonia: a systematic review. Med Sci (Basel). 2019;7(1):1-10.
REN X et al. The distribution characteristics of intestinal microbiota in children with community-acquired pneumonia under five Years of age. Microb Pathog. 2020;142(1):1-10.
KÓZKA M et al. Risk Factors of Pneumonia Associated with Mechanical Ventilation. Int J Environ Res Public Health. 2020;17(2):1-7.
FERRAZ RO, OLIVEIRA-FRIESTINO JK, Francisco PMSB. Pneumonia mortality trends in all Brazilian geographical regions between 1996 and 2012. J. Bras. Pneumol. 2017;43(4):274-9
SHANMUGARAJ B et al. Perspectives on monoclonal antibody therapy as potential therapeutic intervention for Coronavirus disease-19 (COVID-19). Asian Pac J Allergy Immunol. 2020;38(1):10-18.
SOHRABI C et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020;76(1):71-6.
BARRANCO R, VENTURA F. Covid-19 and infection in health-care workers: An emerging problem. Med Leg J. 2020;1-2.
NOBRE V, BORGES I. Valor prognóstico da procalcitonina em pacientes com infecções do trato respiratório inferior no ambiente hospitalar. Rev Bras Ter Intensiva. 2016;28:179-89.
. BACCI MR et al. IL-6 and TNF-? serum levels are associated with early death in community-acquired pneumonia patients. Braz J Med Biol Res. 2015;48:427-32.
. KARAKIOULAKI M, STOLZ D. Biomarkers in Pneumonia-Beyond Procalcitonin. Int J Mol Sci. 2019;20(8):1-18.
. OSTERMANN M, KASHANI K, FORNI LG. The two sides of creatinine: both as bad as each other? J Thorac Dis. 2016;8(7):E628-E630.
. Brasil. Ministério da Saúde. Departamento de Atenção Básica. Área Técnica de Diabetes e Hipertensão Arteiral. Brasil. Ministério da Saúde. Departamento de Atenção Básica. Área Técnica de Diabetes e Hipertensão Arteiral. 2020
STUPKA JE et al. Community-acquired pneumonia in elderly patients. Aging health. 2009;5(6):763-74.
. BRITO V, NIEDERMAN MS. Predicting mortality in the elderly with community-acquired pneumonia: should we design a new car or set a new 'speed limit'? Thorax. 2010;65(11):944-55.
. CORRÊA RA et al. Recomendações para o manejo da pneumonia adquirida na comunidade 2018. J. Bras. Pneumol. 2018;44(5):405-23.
. SUMMAH H, QU J. Biomarkers: a definite plus in pneumonia. mediators of inflammation, 2009;2009(1):1-10.
. PRNJAVORAC B et al. Significance of serum creatinine levels in respiratory insufficiency conditions. Med Arh. 2001;55(4):197-8.
. MURUGAN R et al.. Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival. Kidney Int. 2010;77(6):527-35.
. ABREU KL et al. Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk. Rev Bras Ter Intensiva. 2013;25(2):130-6.
. FLOEGE J, UHLIG S. Kidney calling lung and call back: how organs talk to each other. Nephrol. Dial. Transplant. 2010;25(1),32-4.
. COLLARES GB, PAULINO UHM. Aplicações clínicas atuais da proteína C reativa. Rev Med Minas Gerais. 2006;16(4):227-33.
. WU J et al.Evaluation and significance of C-reactive protein in the clinical diagnosis of severe pneumonia. Exp Ther Med. 2015;10(1):175-80.
. JAVANIAN M et al. Clinical and laboratory findings from patients with COVID-19 pneumonia in Babol North of Iran: a retrospective cohort study. Rom J Intern Med. 2020;0(0);1-15.
. WANG L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect. 2020 Jun;50(4):332-4.
. POPKO K et al. Proinflammatory cytokines IL-6 and TNF-α and the development of inflammation in obese subjects. Eur J Med Res. 2010;15(Suppl 2):120-2.
. TANAKA T, NARAZAKI M, KISHIMOTO T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6(10):1-16.
. PYLE CJ et al. Early IL-6 signalling promotes IL-27 dependent maturation of regulatory T cells in the lungs and resolution of viral immunopathology. PLoS Pathog. 2017;13(9):1-27.
. MEHTA AK, GRACIAS DT, CROFT M. TNF activity and T cells. Cytokine. 2018;101(1):14-8.
. TANG L et al. Severe pneumonia mortality in elderly patients is associated with downregulation of Toll-like receptors 2 and 4 on monocytes. Am J Med Sci. 2014;347(1):34-41.
. BRITO RC et al. The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia. BMC Pulm Med. 2016;16(1):170.
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