PMID- 25409888
OWN - NLM
STAT- MEDLINE
DCOM- 20160515
LR  - 20181113
IS  - 1471-2466 (Electronic)
IS  - 1471-2466 (Linking)
VI  - 14
DP  - 2014 Nov 19
TI  - The impact of concomitant pulmonary infection on immune dysregulation in 
      Pneumocystis jirovecii pneumonia.
PG  - 182
LID - 10.1186/1471-2466-14-182 [doi]
LID - 182
AB  - BACKGROUND: Concurrent infection may be found in Pneumocystis jirovecii pneumonia 
      (PJP) of non-acquired immunodeficiency syndrome (AIDS) patients, however, its 
      impact on immune dysregulation of PJP in non-AIDS patients remains unknown. 
      METHODS: We measured pro-inflammatory cytokines including tumor necrosis factor 
      (TNF)-alpha, interleukin (IL)-1beta, IL-8, IL-17, monocyte chemoattractant protein-1 
      (MCP-1) and anti-inflammatory cytokines including IL-10 and transforming growth 
      factor (TGF)-beta1 and IL-1 receptor antagonist (IL-1RA) and inflammatory markers 
      including high mobility group box 1, Krebs von den Lungen-6, receptor for 
      advanced glycation end product, advanced glycation end product, surfactant 
      protein D in bronchoalveolar lavage fluid (BALF) and blood in 47 pure PcP and 18 
      mixed PJP and other pulmonary infections (mixed PJP) in non-AIDS 
      immunocompromised patients and explored their clinical relevance. The burden of 
      Pneumocystis jirovecii in the lung was determined by counting number of clusters 
      of Pneumocystis jirovecii per slide and the concentration of beta-D-glucan in BALF. 
      PJP severity was determined by arterial oxygen tension/fraction of inspired 
      oxygen concentration ratio, the need of mechanical ventilation and death. 
      RESULTS: Compared with pure PJP group, mixed PJP group had significantly higher 
      BALF levels of IL-1beta, TNF-alpha and IL-8 and significantly higher blood levels of 
      IL-8. The BALF ratios of TNF-alpha/IL-10, IL-8/IL-10, IL-1beta/IL-10, TNF-alpha/TGF-beta1, 
      IL-8/TGF-beta1, IL-1beta/TGF-beta1 and IL-1beta/IL-1RA were significantly higher in mixed 
      than in pure PJP patients. There was no significant difference in clinical 
      features and outcome between pure and mixed PJP groups, including inflammatory 
      biomarkers and the fungal burden. In pure PJP patients, significantly higher BALF 
      levels of IL-8 and the ratios of IL-8/IL-10, IL-1beta/TGF-beta1, MCP-1/TGF-beta1, 
      MCP-1/IL1RA and IL-8/TGF-beta1 were found in the patients requiring mechanical 
      ventilation and in non-survivors. CONCLUSIONS: In summary, concurrent pulmonary 
      infection might enhance immune dysregulation of PJP in non-AIDS immunocompromised 
      patients, but did not affect the outcome as evidenced by morbidity and mortality. 
      Because of limited number of cases studied, further studies with larger 
      populations are needed to verify these issues.
FAU - Chou, Chung-Wei
AU  - Chou CW
FAU - Lin, Fang-Chi
AU  - Lin FC
FAU - Tsai, Han-Chen
AU  - Tsai HC
FAU - Chang, Shi-Chuan
AU  - Chang SC
AD  - Department of Chest Medicine, Taipei Veterans General Hospital, No, 201, Section 
      2, Shih-Pai Road, Taipei 112, Taiwan. scchang@vghtpe.gov.tw.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141119
PL  - England
TA  - BMC Pulm Med
JT  - BMC pulmonary medicine
JID - 100968563
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
RN  - 0 (beta-Glucans)
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/analysis
MH  - Bronchoalveolar Lavage Fluid/*chemistry
MH  - Coinfection/immunology
MH  - Cytokines/*analysis/blood
MH  - Female
MH  - Humans
MH  - Immunocompromised Host/*immunology
MH  - Male
MH  - Middle Aged
MH  - Mycoses/immunology
MH  - Oxygen/blood
MH  - Partial Pressure
MH  - *Pneumocystis carinii
MH  - Pneumonia, Pneumocystis/*immunology
MH  - Respiration, Artificial
MH  - beta-Glucans/analysis
PMC - PMC4247696
EDAT- 2014/11/21 06:00
MHDA- 2016/05/18 06:00
PMCR- 2014/11/19
CRDT- 2014/11/21 06:00
PHST- 2014/08/16 00:00 [received]
PHST- 2014/11/10 00:00 [accepted]
PHST- 2014/11/21 06:00 [entrez]
PHST- 2014/11/21 06:00 [pubmed]
PHST- 2016/05/18 06:00 [medline]
PHST- 2014/11/19 00:00 [pmc-release]
AID - 1471-2466-14-182 [pii]
AID - 613 [pii]
AID - 10.1186/1471-2466-14-182 [doi]
PST - epublish
SO  - BMC Pulm Med. 2014 Nov 19;14:182. doi: 10.1186/1471-2466-14-182.