Background and objective: Community-acquired pneumonia (CAP) is associated with an increased risk of arterial and venous thrombosis but the underlying pathophysiological mechanisms are still unclear. We investigated if, in patients with CAP, a pro-thrombotic state does exist and its relationship with serum levels of endotoxins. Methods: A total of 104 consecutive patients with CAP were prospectively recruited and followed up until discharge. At admission and at discharge, serum endotoxins, systemic markers of clotting activation and zonulin, a marker of gut permeability, were analysed. Hospitalized patients matched for gender, age and comorbidities but without infections were used as control. Results: At admission, CAP patients showed higher plasma levels of F1+2 , a marker of thrombin generation (P = 0.023), and lower levels of protein C (PC; P < 0.001) and activated PC (aPC) (P < 0.001) compared with controls. At discharge, plasma levels of both PC and aPC significantly increased while F1+2 significantly decreased (P < 0.001). Baseline serum endotoxins and zonulin were higher in CAP patients than controls (P < 0.001) and significantly decreased at discharge; a significant correlation between serum endotoxins and zonulin was detected (R = 0.575; P < 0.001) CONCLUSION: This study provides the first evidence that CAP patients disclose an ongoing pro-thrombotic state and suggests a role for endotoxemia in determining enhanced thrombin generation.

Low-grade endotoxemia and clotting activation in the early phase of pneumonia / Cangemi, Roberto; Della Valle, Patrizia; Calvieri, Camilla; Taliani, Gloria; Ferroni, Patrizia; Falcone, Marco; Carnevale, Roberto; Bartimoccia, Simona; D'Angelo, Armando; Violi, Francesco. - In: RESPIROLOGY. - ISSN 1323-7799. - ELETTRONICO. - 21:8(2016), pp. 1465-1471. [10.1111/resp.12854]

Low-grade endotoxemia and clotting activation in the early phase of pneumonia

CANGEMI, ROBERTO;CALVIERI, CAMILLA;TALIANI, Gloria;FALCONE, MARCO;CARNEVALE, Roberto;BARTIMOCCIA, SIMONA;VIOLI, Francesco
2016

Abstract

Background and objective: Community-acquired pneumonia (CAP) is associated with an increased risk of arterial and venous thrombosis but the underlying pathophysiological mechanisms are still unclear. We investigated if, in patients with CAP, a pro-thrombotic state does exist and its relationship with serum levels of endotoxins. Methods: A total of 104 consecutive patients with CAP were prospectively recruited and followed up until discharge. At admission and at discharge, serum endotoxins, systemic markers of clotting activation and zonulin, a marker of gut permeability, were analysed. Hospitalized patients matched for gender, age and comorbidities but without infections were used as control. Results: At admission, CAP patients showed higher plasma levels of F1+2 , a marker of thrombin generation (P = 0.023), and lower levels of protein C (PC; P < 0.001) and activated PC (aPC) (P < 0.001) compared with controls. At discharge, plasma levels of both PC and aPC significantly increased while F1+2 significantly decreased (P < 0.001). Baseline serum endotoxins and zonulin were higher in CAP patients than controls (P < 0.001) and significantly decreased at discharge; a significant correlation between serum endotoxins and zonulin was detected (R = 0.575; P < 0.001) CONCLUSION: This study provides the first evidence that CAP patients disclose an ongoing pro-thrombotic state and suggests a role for endotoxemia in determining enhanced thrombin generation.
2016
endotoxin; pneumonia; protein C; thrombosis; zonulin; Pulmonary and Respiratory Medicine
01 Pubblicazione su rivista::01a Articolo in rivista
Low-grade endotoxemia and clotting activation in the early phase of pneumonia / Cangemi, Roberto; Della Valle, Patrizia; Calvieri, Camilla; Taliani, Gloria; Ferroni, Patrizia; Falcone, Marco; Carnevale, Roberto; Bartimoccia, Simona; D'Angelo, Armando; Violi, Francesco. - In: RESPIROLOGY. - ISSN 1323-7799. - ELETTRONICO. - 21:8(2016), pp. 1465-1471. [10.1111/resp.12854]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/899453
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