Early proinflammatory cytokines and C-reactive protein trends as predictors of outcome in invasive Aspergillosis.
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Publication year
2010Source
The Journal of Infectious Diseases, 202, 9, (2010), pp. 1454-62ISSN
Publication type
Article / Letter to editor
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Organization
Internal Medicine
IQ Healthcare
Health Evidence
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
The Journal of Infectious Diseases
Volume
vol. 202
Issue
iss. 9
Page start
p. 1454
Page end
p. 62
Subject
N4i 2: Invasive mycoses and compromised host; NCMLS 1: Infection and autoimmunityAbstract
BACKGROUND: Monitoring treatment response in invasive aspergillosis is challenging, because an immunocompromised host may not exhibit reliable symptoms and clinical signs. Cytokines play a pivotal role in mediating host immune response to infection; therefore, the profiling of biomarkers may be an appropriate surrogate for disease status. METHODS: We studied, in a cohort of 119 patients with invasive aspergillosis who were recruited in a multicenter clinical trial, serum interleukin (IL)-6, IL-8, IL-10, interferon-gamma, and C-reactive protein (CRP) trends over the first 4 weeks of therapy and correlated these trends to clinical outcome parameters. RESULTS: Circulating IL-6 and CRP levels were high at initiation of therapy and generally showed a downward trend with antifungal treatment. However, subjects with adverse outcomes exhibited a distinct lack of decline in IL-6 and CRP levels at week 1, compared with responders (P = .02, for both IL-6 and CRP). Nonresponders also had significantly elevated IL-8 levels (P = .001). CONCLUSIONS: High initial IL-8 and persistently elevated IL-6, IL-8, and CRP levels after initiation of treatment may be early predictors of adverse outcome in invasive aspergillosis. Cytokine and CRP profiles could be used for early identification of patients with a poor response to antifungal treatment who may benefit from more-aggressive antimicrobial regimens.
This item appears in the following Collection(s)
- Academic publications [238441]
- Electronic publications [122508]
- Faculty of Medical Sciences [90373]
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