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.

Low-grade endotoxemia, gut permeability and platelet activation in community-acquired pneumonia / Cangemi, Roberto; Pignatelli, Pasquale; Carnevale, Roberto; Bartimoccia, Simona; Nocella, Cristina; Falcone, Marco; Taliani, Gloria; Violi, Francesco; Battaglia, Simona; Bertazzoni, Giuliano; Biliotti, Elisa; Calabrese, Cinzia Myriam; Casciaro, Marco; De Angelis, Maurizio; De Marzio, Paolo; Esvan, Rozenn; Fazi, Lucia; Ferro, Domenico; Fontanelli Sulekova, Lucia; Franchi, Cristiana; Giordo, Laura; Grieco, Stefania; Manzini, Elisa; Morelli, Sergio; Palange, Paolo; Pastori, Daniele; Rivano Capparuccia, Marco; Romiti, Giulio Francesco; Rossi, Elisabetta; Ruscio, Eleonora; Russo, Alessandro; Scarpellini, Maria Gabriella; Trapè, Stefano; Toriello, Filippo. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - 73:2(2016), pp. 107-114. [10.1016/j.jinf.2016.05.013]

Low-grade endotoxemia, gut permeability and platelet activation in community-acquired pneumonia

CANGEMI, ROBERTO;PIGNATELLI, Pasquale;CARNEVALE, Roberto;Bartimoccia, Simona;NOCELLA, CRISTINA;FALCONE, MARCO;TALIANI, Gloria;VIOLI, Francesco
;
Battaglia, Simona;BERTAZZONI, Giuliano;BILIOTTI, Elisa;Calabrese, Cinzia Myriam;DE MARZIO, Paolo;Fazi, Lucia;FERRO, Domenico;Grieco, Stefania;MORELLI, Sergio;PALANGE, Paolo;PASTORI, DANIELE;RIVANO CAPPARUCCIA, MARCO;Romiti, Giulio Francesco;SCARPELLINI, Maria Gabriella;
2016

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.
File allegati a questo prodotto
File Dimensione Formato  
Cangemi_Low-Grade_2016.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 815.08 kB
Formato Adobe PDF
815.08 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/901704
Citazioni
  • ???jsp.display-item.citation.pmc??? 20
  • Scopus 35
  • ???jsp.display-item.citation.isi??? 34
social impact