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MIP-3-Alpha and MIP-3-Beta as Early Predictors of Pneumonia in Polytraumatized Patients
Gregor Wollner1, Florian Hruska2, Paul Ettel3
1Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, 1090, Vienna, Austria. gregor.wollner@meduniwien.ac.at.
Introduction:
Pneumonia is one of the most common complications in patients suffering multiple traumas and is associated with an exceptionally high mortality rate. MIP-3-alpha and MIP-3-beta are pro-inflammatory chemokines expressed in the pulmonary mucosa and are reported to play a crucial role in inflammation. Thus, the present study aimed to investigate whether there is an association between MIP-3-alpha- and MIP-3-beta expression and manifestation of pneumonia in patients suffering polytrauma.
Material And Methods:
This prospective outcome study was conducted at our level I trauma center, and 110 polytraumatized patients (Injury Severity Score ≥ 16, ≥ 2 body regions) were prospectively enrolled (median age, 39 years; median Injury Severity Score (ISS), 33; 70.9% male) over four years. Protein levels were assessed at admission (day 0) and subsequently on days 1, 3, 5, 7, and 10 during routine blood draws, utilizing one separation gel tube for each measurement. Furthermore, the correlation between MIP-3-alpha- and MIP-3-beta expression and the manifestation of pneumonia was calculated.
Results:
We observed significantly higher levels of MIP-3-beta expression over the entire time course in the pneumonia cohort. MIP-3-alpha levels were elevated on days 3, 5, 7, and 10 post-trauma in patients suffering from pneumonia. In contrast, no comparable pattern was observed for other pro- and anti-inflammatory cytokines (e.g., IL-6 or TNF-alpha). A peak of serum level expression was documented on day 5 in both biomarkers (MIP-3-alpha 51.8 pg/mL; MIP-3-beta 328.0 pg/mL). ROC analysis provided a cut-off value of 19.3 pg/mL (sensitivity 0.87, specificity 0.33; AUC 0.757) for MIP-3-alpha, whereas a cut-off value of 209.5 pg/mL (sensitivity 0.78, specificity 0.34; AUC 0.757) was determined for MIP-3-beta on day 5.
Conclusion:
The present study demonstrated elevated MIP-3-alpha and MIP-3-beta levels as sensitive pneumonia predictors in patients with multiple traumas. These biomarkers allow for identifying patients at high risk of developing pneumonia at an early stage.
Insights
Elevated levels of MIP-3-alpha and MIP-3-beta chemokines indicate a higher risk of pneumonia in polytrauma patients. These biomarkers can help identify at-risk individuals early for timely intervention.
Area of Science:
- Immunology
- Critical Care Medicine
- Pulmonology
Background:
- Pneumonia is a frequent and fatal complication in polytrauma patients.
- Pro-inflammatory chemokines MIP-3-alpha and MIP-3-beta play roles in inflammation.
Purpose of the Study:
- To investigate the association between MIP-3-alpha and MIP-3-beta expression and pneumonia development in polytrauma patients.
Main Methods:
- Prospective study of 110 polytrauma patients (ISS ≥ 16).
- MIP-3-alpha and MIP-3-beta levels measured on days 0, 1, 3, 5, 7, and 10 post-trauma.
- Correlation analysis between chemokine levels and pneumonia manifestation.
Main Results:
- Significantly higher MIP-3-beta levels observed throughout in the pneumonia cohort.
- Elevated MIP-3-alpha levels noted on days 3-10 post-trauma in pneumonia patients.
- ROC analysis identified cut-off values for MIP-3-alpha (19.3 pg/mL) and MIP-3-beta (209.5 pg/mL) on day 5.
Conclusions:
- Elevated MIP-3-alpha and MIP-3-beta levels are sensitive predictors of pneumonia in polytrauma.
- These chemokines aid in early identification of high-risk patients for pneumonia development.
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