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Association of the Tyrosine/Nitrotyrosine pathway with death or ICU admission within 30 days for patients with community acquired pneumonia.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2018 Aug 24; Vol. 18 (1), pp. 423. Date of Electronic Publication: 2018 Aug 24. - Publication Year :
- 2018
-
Abstract
- Background: Oxidative stress is a modifiable risk-factor in infection causing damage to human cells. As an adaptive response, cells catabolize Tyrosine to 3-Nitrotyrosine (Tyr-NO2) by nitrosylation. We investigated whether a more efficient reduction in oxidative stress, mirrored by a lowering of Tyrosine, and an increase in Tyr-NO2 and the Tyrosine/Tyr-NO2 ratio was associated with better clinical outcomes in patients with community-acquired pneumonia (CAP).<br />Methods: We measured Tyrosine and Tyr-NO2 in CAP patients from a previous randomized Swiss multicenter trial. The primary endpoint was adverse outcome defined as death or ICU admission within 30-days; the secondary endpoint was 6-year mortality.<br />Results: Of 278 included CAP patients, 10.4% experienced an adverse outcome within 30 days and 45.0% died within 6 years. After adjusting for the pneumonia Severity Index [PSI], BMI and comorbidities, Tyrosine nitrosylation was associated with a lower risk for short-term adverse outcome and an adjusted OR of 0.44 (95% CI 0.20 to 0.96, p = 0.039) for Tyr-NO2 and 0.98 (95% CI 0.98 to 0.99, p = 0.043) for the Tyrosine/Tyr-NO2 ratio. There were no significant associations for long-term mortality over six-years for Tyr-NO2 levels (adjusted hazard ratio 0.81, 95% CI 0.60 to 1.11, p = 0.181) and Tyrosine/Tyr-NO2 ratio (adjusted hazard ratio 1.00, 95% CI 0.99 to 1.00, p = 0.216).<br />Conclusions: Tyrosine nitrosylation in our cohort was associated with better clinical outcomes of CAP patients at short-term, but not at long term. Whether therapeutic modulation of the Tyrosine/Tyr-NO2 pathway has beneficial effects should be evaluated in future studies.<br />Trial Registration: ISRCTN95122877. Registered 31 July 2006.
- Subjects :
- Aged
Aged, 80 and over
Cohort Studies
Community-Acquired Infections diagnosis
Community-Acquired Infections metabolism
Community-Acquired Infections mortality
Female
Follow-Up Studies
Humans
Intensive Care Units statistics & numerical data
Male
Metabolic Networks and Pathways
Middle Aged
Mortality
Pneumonia diagnosis
Pneumonia metabolism
Pneumonia mortality
Prognosis
Risk Factors
Switzerland epidemiology
Time Factors
Tyrosine metabolism
Community-Acquired Infections epidemiology
Patient Admission statistics & numerical data
Pneumonia epidemiology
Tyrosine analogs & derivatives
Tyrosine blood
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 30143005
- Full Text :
- https://doi.org/10.1186/s12879-018-3335-y