Roberto Cangemi1, Pasquale Pignatelli1, Roberto Carnevale1, Simona Bartimoccia1, Cristina Nocella1, Marco Falcone2, Gloria Taliani3, Francesco Violi4. 1. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy. 2. Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy. 3. Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, Italy. 4. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy. Electronic address: francesco.violi@uniroma1.it.
Abstract
OBJECTIVES: Platelet activation seems to be implicated in the cardiovascular events occurring in patients with community-acquired pneumonia (CAP) but the underlying mechanism is still unclear. Aim of the study was to assess the mechanism involved in platelet activation in CAP patients. METHODS: Two-hundred-seventy-eight consecutive patients hospitalized for CAP were recruited and followed-up until discharge. Hospitalized patients matched for sex, age and comorbidities but without acute infectious diseases were used as controls. RESULTS: At hospital admission patients disclosed enhanced plasma levels of sP-selectin, a maker of in-vivo platelet activation, serum sNOX2-dp, a marker of NADPH-oxidase activation, serum Lipopolysaccharide (LPS) and serum zonulin, a marker of gut permeability, compared to controls (p < 0.001). Baseline sP-selectin was independently associated to serum LPS, sNOX2-sp and Pneumonia Severity Index score (p < 0.001). Plasma sP-selectin, serum sNOX2-dp, LPS and zonulin coincidentally decreased at hospital discharge (p < 0.001). An in vitro study showed that LPS, at concentration similar to that found in CAP patients, induced sP-selectin release by agonist-activated platelets, a phenomenon that was counteract by treating cells with gp91ds-tat, a specific inhibitor of NOX2. CONCLUSIONS: CAP patients display enhanced platelet activation, which is related to LPS-mediated NOX2 activation. Enhanced gut permeability seems be implicated in enhancing circulating levels of LPS.
OBJECTIVES: Platelet activation seems to be implicated in the cardiovascular events occurring in patients with community-acquired pneumonia (CAP) but the underlying mechanism is still unclear. Aim of the study was to assess the mechanism involved in platelet activation in CAP patients. METHODS: Two-hundred-seventy-eight consecutive patients hospitalized for CAP were recruited and followed-up until discharge. Hospitalized patients matched for sex, age and comorbidities but without acute infectious diseases were used as controls. RESULTS: At hospital admission patients disclosed enhanced plasma levels of sP-selectin, a maker of in-vivo platelet activation, serum sNOX2-dp, a marker of NADPH-oxidase activation, serum Lipopolysaccharide (LPS) and serum zonulin, a marker of gut permeability, compared to controls (p < 0.001). Baseline sP-selectin was independently associated to serum LPS, sNOX2-sp and Pneumonia Severity Index score (p < 0.001). Plasma sP-selectin, serum sNOX2-dp, LPS and zonulin coincidentally decreased at hospital discharge (p < 0.001). An in vitro study showed that LPS, at concentration similar to that found in CAP patients, induced sP-selectin release by agonist-activated platelets, a phenomenon that was counteract by treating cells with gp91ds-tat, a specific inhibitor of NOX2. CONCLUSIONS: CAP patients display enhanced platelet activation, which is related to LPS-mediated NOX2 activation. Enhanced gut permeability seems be implicated in enhancing circulating levels of LPS.
Authors: Jan K Nowak; Irena Wojsyk-Banaszak; Edyta Mądry; Andrzej Wykrętowicz; Patrycja Krzyżanowska; Sławomira Drzymała-Czyż; Agata Nowicka; Andrzej Pogorzelski; Ewa Sapiejka; Wojciech Skorupa; Mariusz Szczepanik; Aleksandra Lisowska; Jaroslaw Walkowiak Journal: Lung Date: 2017-06-23 Impact factor: 2.584
Authors: Francesco Violi; Jonel Trebicka; Alexander Queck; Roberto Carnevale; Frank Erhard Uschner; Robert Schierwagen; Sabine Klein; Christian Jansen; Carsten Meyer; Michael Praktiknjo; Daniel Thomas; Christian Strassburg; Stefan Zeuzem Journal: Gut Date: 2019-07-03 Impact factor: 23.059