期刊
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
卷 20, 期 10, 页码 1261-1274出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2021.1834848
关键词
Biomarkers; community-acquired pneumonia; corticosteroids; immunoglobulins; immunomodulation; inflammatory response; influenza; macrolides; metabolomics; statins
资金
- Instituto de Salud Carlos III, Spanish Ministry of Science, Innovation and Universities [FI18/00183]
- European Social Funds invests in your future
- Plan Nacional de I+D+ [i 2013-2016 378]
- Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Spanish Network for Research in Infectious Diseases [REIPI RD16/0016/0005]
- European Development Regional Fund A way to achieve Europe, Operative program Intelligent Growth 382 2014-2020 [201808-10]
- La Marato de TV3
- CERCA Programme/Generalitat de Catalunya
Despite ongoing efforts to identify biomarkers and effective treatment strategies for modulating the inflammatory response in CAP, ideal solutions have yet to be found. The contradictory results in studies concerning the role of immunomodulatory agents further complicates the task of adequately identifying the population who may benefit most.
Introduction Despite adequate antibiotic coverage, community-acquired pneumonia (CAP) remains a leading cause of hospitalization and mortality worldwide. It induces both a local pulmonary and a systemic inflammatory response, particularly significant in severe cases. The intensity of the dysregulated host response varies from patient to patient and has a negative impact on survival and other outcomes. Areas covered This comprehensive review summarizes the pathophysiological aspects of the inflammatory response in CAP, briefly discusses the usefulness of biomarkers, and assesses the clinical evidence for modulating the inflammatory pathways. We searched PubMed for the most relevant studies, reviews, and meta-analysis until August 2020. Expert opinion Notable efforts have been made to identify biomarkers that can accurately differentiate between viral and bacterial etiology, and indeed, to enhance risk stratification in CAP. However, none has proven ideal and no recommended biomarker-guided algorithms exist. Biomarker signatures from proteomic and metabolomic studies could be more useful for such assessments. To date, most studies have produced contradictory results concerning the role of immunomodulatory agents (e.g. corticosteroids, macrolides, and statins) in CAP. Adequately identifying the population who may benefit most from effective modulation of the inflammatory response remains a challenge.
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