1. Low-grade endotoxemia, gut permeability and platelet activation in community-acquired pneumonia
- Author
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Sergio Morelli, Maria Gabriella Scarpellini, Marco Falcone, Lucia Fazi, Gloria Taliani, Francesco Violi, Elisa Biliotti, Filippo Toriello, Cristiana Franchi, Daniele Pastori, Giulio Francesco Romiti, Roberto Carnevale, Stefano Trapè, Marco Antonio Casciaro, Paolo De Marzio, Giuliano Bertazzoni, Cinzia Myriam Calabrese, Laura Giordo, Simona Bartimoccia, Roberto Cangemi, Domenico Ferro, Pasquale Pignatelli, Marco Rivano Capparuccia, Maurizio De Angelis, S. Grieco, Paolo Palange, Elisa Manzini, Eleonora Ruscio, Cristina Nocella, Rozenn Esvan, Alessandro Russo, Simona Battaglia, Elisabetta Rossi, and Lucia Fontanelli Sulekova
- Subjects
Microbiology (medical) ,Adult ,Lipopolysaccharides ,Male ,P-selectin ,Lipopolysaccharide ,030204 cardiovascular system & hematology ,Blood platelets ,Endotoxins ,NADPH oxidase ,Pneumonia ,Infectious Diseases ,Permeability ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Community-acquired pneumonia ,medicine ,Humans ,Platelet ,030212 general & internal medicine ,Platelet activation ,Aged ,Membrane Glycoproteins ,biology ,business.industry ,Zonulin ,NADPH Oxidases ,Middle Aged ,medicine.disease ,Platelet Activation ,Endotoxemia ,Community-Acquired Infections ,Intestines ,P-Selectin ,chemistry ,Immunology ,NADPH Oxidase 2 ,biology.protein ,Female ,business - Abstract
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.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.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.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.
- Published
- 2016