Related Experiment Video
Updated: Jan 31, 2026
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Low Admission Plasma Gelsolin Concentrations Identify Community-acquired Pneumonia Patients at High Risk for Severe
Wesley H Self1, Richard G Wunderink2, Mark J DiNubile3
1Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Insights
Low plasma gelsolin (pGSN) levels at hospital admission for community-acquired pneumonia (CAP) indicate a higher risk of severe outcomes. This finding highlights pGSN as a potential biomarker for CAP severity.
Area of Science:
- Biochemistry
- Immunology
- Pulmonology
Background:
- Plasma gelsolin (pGSN) is a key protein involved in cellular defense and inflammation.
- pGSN neutralizes actin from damaged cells, modulates immune responses, and boosts macrophage antimicrobial activity.
Purpose of the Study:
- To determine if low plasma gelsolin (pGSN) levels at hospital admission for community-acquired pneumonia (CAP) predict severe clinical outcomes.
- To investigate the association between admission pGSN concentrations and CAP severity.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to measure pGSN concentrations in 455 hospitalized CAP patients.
- Patients were categorized by maximum clinical severity: floor care, ICU care, invasive respiratory or vasopressor support (IRVS), or death.
- pGSN levels were compared across severity groups and between the lowest pGSN quartile and the upper three quartiles.
Main Results:
- Median pGSN concentration was 38.1 μg/mL; lower levels correlated with increased severity (P = .0001).
- Patients who died had significantly lower median pGSN (25.7 μg/mL) compared to floor patients (40.3 μg/mL).
- The lowest pGSN quartile (≤ 32.1 μg/mL) was associated with higher rates of IRVS (21.2% vs 11.7%, P = .0114) and mortality (8.8% vs 0.9%, P < .0001).
Conclusions:
- Lower plasma gelsolin (pGSN) concentrations at hospital admission are linked to more severe outcomes in adults with community-acquired pneumonia (CAP).
- pGSN may serve as a prognostic biomarker for CAP severity.
- Future research will explore the therapeutic potential of recombinant human pGSN in CAP patients.
Background:
Plasma gelsolin (pGSN) is an abundant circulating protein that neutralizes actin exposed by damaged cells, modulates inflammatory responses, and enhances alveolar macrophage antimicrobial activity. We investigated whether adults with low pGSN at hospital admission for community-acquired pneumonia (CAP) were at high risk for severe outcomes.
Methods:
Admission pGSN concentrations in 455 adults hospitalized with CAP were measured using enzyme-linked immunosorbent assay. Patients were grouped into the following 4 hierarchical, mutually exclusive categories based on maximum clinical severity experienced during their hospitalization: general floor care without intensive care unit (ICU) admission, invasive respiratory or vasopressor support (IRVS), or death; ICU care without IRVS or death; IRVS without death; or death. Admission pGSN concentrations were compared across these discrete outcome categories. Additionally, outcomes among patients in the lowest quartile of pGSN concentration were compared to those in the upper 3 quartiles.
Results:
Overall, median (interquartile range) pGSN concentration was 38.1 (32.1, 45.7) μg/mL. Patients with more severe outcomes had lower pGSN concentrations (P = .0001); median values were 40.3 μg/mL for floor patients, 36.7 μg/mL for ICU patients, 36.5 μg/mL for patients receiving IRVS, and 25.7 μg/mL for patients who died. Compared to patients with higher pGSN concentrations, patients in the lowest quartile (pGSN ≤ 32.1 μg/mL) more often required IRVS (21.2% vs 11.7%, P = .0114) and died (8.8% vs 0.9%, P < .0001).
Conclusions:
Among adults hospitalized with CAP, lower pGSN concentrations were associated with more severe clinical outcomes. Future studies are planned to investigate possible therapeutic benefits of recombinant human pGSN in this population.
Related Concept Videos
00:30What are Populations and Communities?
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
02:24Predicting Reaction Outcomes
01:12Relative Risk
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...