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The Plasma Lipidomic Landscape in Patients with Sepsis due to Community-acquired Pneumonia.
Chouchane, Osoul; Schuurman, Alex R; Reijnders, Tom D Y; Peters-Sengers, Hessel; Butler, Joe M; Uhel, Fabrice; Schultz, Marcus J; Bonten, Marc J; Cremer, Olaf L; Calfee, Carolyn S; Matthay, Michael A; Langley, Raymond J; Alipanah-Lechner, Narges; Kingsmore, Stephen F; Rogers, Angela; van Weeghel, Michel; Vaz, Frédéric M; van der Poll, Tom.
Afiliação
  • Chouchane O; Center for Experimental and Molecular Medicine.
  • Schuurman AR; Center for Experimental and Molecular Medicine.
  • Reijnders TDY; Center for Experimental and Molecular Medicine.
  • Peters-Sengers H; Center for Experimental and Molecular Medicine.
  • Butler JM; Center for Experimental and Molecular Medicine.
  • Uhel F; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche S1151, Centre National de la Recherche Scientifique Unité Mixte de Recherche S8253, Institut Necker-Enfants Malades, Université Paris Cité, Paris, France.
  • Schultz MJ; Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, DMU ESPRIT, Colombes, France.
  • Bonten MJ; Department of Intensive Care Medicine.
  • Cremer OL; Laboratory of Experimental Intensive Care and Anesthesiology.
  • Calfee CS; Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
  • Matthay MA; Department of Medical Microbiology.
  • Langley RJ; Julius Center for Health Sciences and Primary Care, and.
  • Alipanah-Lechner N; Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Kingsmore SF; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California.
  • Rogers A; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, California.
  • van Weeghel M; Department of Pharmacology, University of South Alabama College of Medicine, Mobile, Alabama.
  • Vaz FM; Division of Pulmonary and Critical Care, Department of Medicine, Stanford, California; and.
  • van der Poll T; Rady Children's Institute for Genomic Medicine, Rady Children's Hospital, San Diego, California.
Am J Respir Crit Care Med ; 209(8): 973-986, 2024 04 15.
Article em En | MEDLINE | ID: mdl-38240721
ABSTRACT
Rationale The plasma lipidome has the potential to reflect many facets of the host status during severe infection. Previous work is limited to specific lipid groups or was focused on lipids as prognosticators.

Objectives:

To map the plasma lipidome during sepsis due to community-acquired pneumonia (CAP) and determine the disease specificity and associations with clinical features.

Methods:

We analyzed 1,833 lipid species across 33 classes in 169 patients admitted to the ICU with sepsis due to CAP, 51 noninfected ICU patients, and 48 outpatient controls. In a paired analysis, we reanalyzed patients still in the ICU 4 days after admission (n = 82).Measurements and Main

Results:

A total of 58% of plasma lipids were significantly lower in patients with CAP-attributable sepsis compared with outpatient controls (6% higher, 36% not different). We found strong lipid class-specific associations with disease severity, validated across two external cohorts, and inflammatory biomarkers, in which triacylglycerols, cholesterol esters, and lysophospholipids exhibited the strongest associations. A total of 36% of lipids increased over time, and stratification by survival revealed diverging lipid recovery, which was confirmed in an external cohort; specifically, a 10% increase in cholesterol ester levels was related to a lower odds ratio (0.84; P = 0.006) for 30-day mortality (absolute mortality, 18 of 82). Comparison with noninfected ICU patients delineated a substantial common illness response (57.5%) and a distinct lipidomic signal for patients with CAP-attributable sepsis (37%).

Conclusions:

Patients with sepsis due to CAP exhibit a time-dependent and partially disease-specific shift in their plasma lipidome that correlates with disease severity and systemic inflammation and is associated with higher mortality.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Infecções Comunitárias Adquiridas / Sepse Limite: Humans Idioma: En Revista: Am J Respir Crit Care Med Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Infecções Comunitárias Adquiridas / Sepse Limite: Humans Idioma: En Revista: Am J Respir Crit Care Med Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2024 Tipo de documento: Article