Format

Send to

Choose Destination
Eur Respir J. 2018 Apr 26;51(4). pii: 1701389. doi: 10.1183/13993003.01389-2017. Print 2018 Apr.

Markers of neutrophil extracellular traps predict adverse outcome in community-acquired pneumonia: secondary analysis of a randomised controlled trial.

Author information

1
Division of Endocrinology, Diabetes and Clinical Nutrition, Dept of Internal Medicine, University of Basel Hospital, Basel, Switzerland.
2
Division of Rheumatology, Dept of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland.
3
Dept of Biomedicine/University Women's Hospital, University of Basel Hospital, Basel, Switzerland.
4
University Dept of Medicine, Kantonsspital Aarau, Aarau, Switzerland.
5
Dept of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
6
These authors contributed equally to this work.
7
Division of Rheumatology, Dept of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland paul.hasler@ksa.ch.

Abstract

Neutrophil extracellular traps (NETs) are a hallmark of the immune response in inflammatory diseases. However, the role of NETs in community-acquired pneumonia (CAP) is unknown. This study aims to characterise the impact of NETs on clinical outcomes in pneumonia.This is a secondary analysis of a randomised controlled, multicentre trial. Patients with CAP were randomly assigned to either 50 mg prednisone or placebo for 7 days. The primary end-point was time to clinical stability; main secondary end-points were length of hospital stay and mortality.In total, 310 patients were included in the analysis. Levels of cell-free nucleosomes as surrogate markers of NETosis were significantly increased at admission and declined over 7 days. NETs were significantly associated with reduced hazards of clinical stability and hospital discharge in multivariate adjusted analyses. Moreover, NETs were associated with a 3.8-fold increased adjusted odds ratio of 30-day mortality. Prednisone treatment modified circulatory NET levels and was associated with beneficial outcome.CAP is accompanied by pronounced NET formation. Patients with elevated serum NET markers were at higher risk for clinical instability, prolonged length of hospital stay and 30-day all-cause mortality. NETs represent a novel marker for outcome and a possible target for adjunct treatments of pneumonia.

Conflict of interest statement

Conflict of interest: F. Ebrahimi reports receiving grants from Research Funds of the University of Basel during the conduct of the study. S. Giaglis reports receiving grants from Kantonsspital Aarau Research Council during the conduct of the study and has a patent (US 20160061824 A1) pending. S. Hahn has a patent (US 20160061824 A1) pending. C.A. Blum reports receiving grants from Research Funds Endocrinology Kantonsspital Aarau during the conduct of the study. M. Christ-Crain reports receiving grants from the Swiss National Science Foundation, the Gottfried and Julia Bangerter-Rhyner Foundation and the Nora van Meeuwen Häfliger Foundation, during the conduct of the study. P. Hasler reports receiving grants from the Kantonsspital Aarau Research Council during the conduct of the study and has a patent (US 20160061824 A1) pending.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center