Monocyte Chemoattractant Protein-1, a Possible Biomarker of Multiorgan Failure and Mortality in Ventilator-Associated Pneumonia

Abstract

Ventilator-associated pneumonia (VAP) leads to increased patients’ mortality and medical expenditure. Monocyte chemoattractant protein-1 (MCP-1) plays a role in the pathogenesis of lung inflammation and infection. Therefore, the plasma concentration of MCP-1 was assessed and correlated with the clinical course in VAP patients. This retrospective observational study recruited 45 healthy volunteers, 12 non-VAP subjects, and 30 VAP patients. The diagnostic criteria for VAP were based on the American Thoracic Society guidelines, and the level of plasma MCP-1 was determined by ELISA. Plasma MCP-1 concentration was significantly elevated in the acute stage in VAP patients when compared with the control (p < 0.0001) and non-VAP patient groups (p = 0.0006). Subsequently, it was remarkably decreased following antibiotic treatment. Moreover, plasma MCP-1 concentration was positively correlated with indices of pulmonary dysfunction, including the lung injury score (p = 0.02) and the oxygenation index (p = 0.02). When patients with VAP developed adult respiratory distress syndrome (ARDS), their plasma MCP-1 concentrations were significantly higher than those of patients who did not develop ARDS (p = 0.04). Moreover, plasma MCP-1 concentration was highly correlated with organ failure scores, including simplified acute physiology score II (SAPS II, p < 0.0001), sequential organ failure assessment score (SOFA, p < 0.0001), organ dysfunctions and/or infection (ODIN, p < 0.0001), predisposition, insult response and organ dysfunction (PIRO, p = 0.005), and immunodeficiency, blood pressure, multilobular infiltrates on chest radiograph, platelets and hospitalization 10 days before onset of VAP (IBMP-10, p = 0.004). Our results demonstrate that plasma MCP-1 is an excellent marker for recognizing VAP when the cut-off level is set to 347.18 ng/mL (area under the curve (AUC) = 0.936, 95% CI = 0.863–0.977). In conclusion, MCP-1 not only could be a biological marker related to pulmonary dysfunction, organ failure, and mortality in patients with VAP, but also could be used for early recognition of VAP.

Rice Protein Exerts Anti-Inflammatory Effect in Growing and Adult Rats via Suppressing NF-κB Pathway

“…Upon activation of NF-κB, the transcription of a number of inflammatory genes can be activated, e.g., tumor necrotic factor alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), monocyte chemoattractant protein-1 (MCP-1), etc. [1,[16][17][18][19]. This is the basic functional mechanism through which the NF-κB transcription factor induces an inflammatory response.…”

Systemic Inflammation in Oncologic Patients Undergoing Systemic Treatment and Receiving Whey Protein-Based Nutritional Support

“…Other studies have suggested that MCP-1 has also a key role in angiogenesis, tumor invasion capacity, metastasis and immune cell infiltration in solid tumors [ 40 ]. Its clinical relation with increased mortality has been reported in different scenarios, including critic patients, sepsis and coronary disease [ 41 , 42 , 43 ]. In this context, its modulation has been tested in animal models with poor results [ 44 ], but the clear association with mortality observed in our study suggests that that should be further evaluated as a putative therapeutic marker that could improve mortality rates.…”

Association Between Plasma Levels of Monocyte Chemoattractant Protein-1 (MCP-1) and 28-Day Mortality in Elderly Patients with Sepsis: A Retrospective Single-Center Study

“…MCP-1 played a significant role in the inflammatory processes of various organs. In the context of ventilator-associated pneumonia pathogenesis, the concentration of plasma MCP-1 exhibited a positive correlation with the severity of lung damage [ 34 ]. MCP-1 was found to be involved in the local immunity of pulmonary inflammatory exudation, and its effect could not be replaced by other monocyte chemokines such as chemokine ligand 7 and chemokine ligand 12 [ 35 ].…”