Cytokines and Cortisol – predictors of treatment response to corticosteroids in community‐acquired pneumonia?

Urwyler, Sandrine Andrea; Blum, C; Coslovsky, Michael; Müeller, Beat; Schuetz, Philipp

doi:10.1111/joim.12891

Cited by 13 publications

(13 citation statements)

References 22 publications

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“…Corticosteroids may be a double-edged sword in the management of immunomodulation and inflammatory response. Its pharmacological mechanisms involve reducing inflammatory cytokines production, leukocyte infiltration and phagocytosis at the onset of inflammation (29,30). Besides, the corticosteroid can interfere with the interaction between proinflammatory factors (31,32).…”

Section: The Onset Time Of Crs and Administration Time Of Corticosteroids/ Tocilizumab Were Associated With Severity Of Crs And Cardiac Dmentioning

confidence: 99%

An Analysis of Cardiac Disorders Associated With Chimeric Antigen Receptor T Cell Therapy in 126 Patients: A Single-Centre Retrospective Study

Zhang

Cheng

et al. 2021

Front. Oncol.

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IntroductionChimeric antigen receptor T (CAR-T) cells are effective in treating hematological malignancies. However, in patients receiving CAR-T therapy, data characterizing cardiac disorders are limited.Methods126 patients with hematologic malignancies receiving CAR-T cell therapy were analyzed to determine the impact of CAR-T therapy on occurrence of cardiac disorders, including heart failure, arrhythmias, myocardial infarction, which were defined by the Common Terminology Criteria for Adverse Events (CTCAE). Parameters related to cardiac disorders were detected including myocardial enzyme, NT-proBNP and ejection fraction (EF). Cardiovascular (CV) events included decompensated heart failure (HF), clinically significant arrhythmias and CV death.ResultsThe median age of patients was 56 years (6 to 72 years). 58% patients were male, 62% had multiple myeloma, 20% had lymphoma and 18% had ALL. 33 (26%) patients had cardiac disorders, most of which were grade 1-2. 13 patients (10%) were observed with cardiac disorders grade 3-5, which comprised 5(4%) patients with new-onset HF, 2 (2%) patients with new-onset arrhythmias, 4 (3%) patients with the acute coronary syndrome, 1(1%) patient with myocardial infarction and 1(1%) patient with left ventricular systolic dysfunction. There were 9 CV events (7%) including 6 decompensated heart failure, 1 clinically significant arrhythmias and 2 CV deaths. Among the 33 patients with cardiac disorders, the patients with cardiac disorders CTCAE grade 3-5 had higher grade CRS (grade ≥ 3) than those with cardiac disorders CTCAE grade ≤ 2 (P <0.001). More patients with cardiac disorders CTCAE grade 3-5 were observed in the cohort who did not receive corticosteroids and/or tocilizumab therapy timely comparing with those who received corticosteroids and/or tocilizumab therapy timely (P =0.0004).ConclusionsCardiac disorders CAR-T cell therapy were common and associated with occurrence of CRS. However, most cases were mild. For patients with CRS grade 3-5, timely administration of corticosteroids and/or tocilizumab can effectively prevent the occurrence and progression of cardiac disorders.

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Section: The Onset Time Of Crs and Administration Time Of Corticosteroids/ Tocilizumab Were Associated With Severity Of Crs And Cardiac Dmentioning

confidence: 99%

An Analysis of Cardiac Disorders Associated With Chimeric Antigen Receptor T Cell Therapy in 126 Patients: A Single-Centre Retrospective Study

Zhang

Cheng

et al. 2021

Front. Oncol.

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“…10,11 More information is necessary given that variation in the inflammatory pattern by different variables may impact prognosis and patient selection for future studies of biomarker-guided therapy, which may improve outcomes in patients with CAP. 12 Adequate classification is critical to the clinical applicability of personalized medicine in diagnostics and prognostics for CAP and sepsis.…”

Section: Introductionmentioning

confidence: 99%

“…It is therefore necessary to increase our knowledge of the host response and pattern of inflammatory marker response in CAP, but information about levels of some biomarkers by sociodemographic features in the host is scarce 10,11 . More information is necessary given that variation in the inflammatory pattern by different variables may impact prognosis and patient selection for future studies of biomarker‐guided therapy, which may improve outcomes in patients with CAP 12 . Adequate classification is critical to the clinical applicability of personalized medicine in diagnostics and prognostics for CAP and sepsis.…”

Section: Introductionmentioning

confidence: 99%

Effects of age and comorbidities on serum levels of inflammatory markers in community‐acquired pneumonia

Viasus

Simonetti

Estupiñan-Bohorquez

et al. 2021

Eur J Clin Investigation

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Introduction: Studies have suggested that an inappropriate inflammatory response is a major cause of treatment failure and mortality in patients with community-acquired pneumonia (CAP). We aimed to determine the effect of age and comorbidities on serum inflammatory markers in CAP. Methods: We performed a prospective cohort study of adults hospitalized with CAP.For the purposes of this study, we compared patients according to comorbidities and age. Inflammatory markers were measured at hospital admission, focusing on acute phase proteins, cytokines and monocyte human leucocyte antigen DR (mHLA-DR) expression. Results: In patients with chronic pulmonary disease (COPD), serum cytokines had significantly decreased levels of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and mHLA-DR expression, as well as the C-reactive protein (CRP), compared with patients who had no comorbidities. Similarly, patients with chronic heart disease had a significantly reduced CRP levels and mHLA-DR expression, whereas patients with chronic kidney disease had significantly higher serum levels of procalcitonin and TNF-α. Lower procalcitonin, IL-6 and IL-10 levels, as well as mHLA-DR expression, were documented in older patients, but with no significant differences compared to younger patients. Multimorbidity in older patients was associated with significant lower levels of CRP and mHLA-DR expression. Conclusions: The circulating inflammatory markers to CAP have profiles that differ with age and underlying comorbidities. Multimorbidity in the elderly is also associated with lower serum levels of some inflammatory markers. Our findings suggest that inflammatory markers in CAP should be interpreted after considering age and comorbid conditions.

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“…Therefore, cortisol, as a marker of adrenal function, has demonstrated that it may help in prognosis prediction [99][100][101]. In addition, its measurement could identify the response of patients to steroids [102]. Meanwhile, high levels of the fibroblast growth factor 21 (FGF21) have recently been related to poor short-term prognosis in CAP patients from two randomised clinical trials [121].…”

Section: Othersmentioning

confidence: 99%

Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

Méndez

Aldás

Menéndez

2020

JCM

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Community-acquired pneumonia (CAP) remains the first cause of morbidity and mortality worldwide due to infection. Several aspects such as severity and host response are related to its clinical course and outcome. Beyond the acute implications that the infection provokes in the host, pneumonia also has long-term negative consequences. Among them, cardiovascular complications and mortality are the most outstanding. Therefore, an adequate recognition and stratification of the risk of complications and mortality is crucial. Many biomarkers have been studied for these reasons, considering that each biomarker mirrors a different aspect. Moreover, the clinical application of many of them is still being deliberated because of their limitations and the heterogeneity of the disease. In this review, we examine some of the most relevant biomarkers that we have classified as cardiac and non-cardiac. We discuss some classic biomarkers and others that are considered novel biomarkers, which are mainly involved in cardiovascular risk.

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Cytokines and Cortisol – predictors of treatment response to corticosteroids in community‐acquired pneumonia?

Abstract: Urwyler

Cited by 13 publications

References 22 publications

An Analysis of Cardiac Disorders Associated With Chimeric Antigen Receptor T Cell Therapy in 126 Patients: A Single-Centre Retrospective Study

An Analysis of Cardiac Disorders Associated With Chimeric Antigen Receptor T Cell Therapy in 126 Patients: A Single-Centre Retrospective Study

Effects of age and comorbidities on serum levels of inflammatory markers in community‐acquired pneumonia

Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

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