Usefulness of Plasma YKL-40 in Management of Community-Acquired Pneumonia Severity in Patients

Abstract

Plasma YKL-40 level has been reported as playing a significant role in community-acquired pneumonia (CAP). However, the correlation between plasma level of YKL-40 and the severity of CAP has not been reported. This study identifies the relationship between plasma level changes of the YKL-40 gene in adult patients hospitalized with CAP. The ELISA was used to measure the plasma YKL-40 level from 61 adult CAP patients before and after antibiotic treatment and from 60 healthy controls. The plasma YKL-40 levels were significantly increased in patients with CAP compared to normal controls. Moreover, the plasma concentration of YKL-40 correlated with the severity of CAP based on the pneumonia severity index (PSI) score (r = 0.630, p < 0.001), the CURB-65 (confusion, uremia, respiratory rate, BP, age 65 years) score (r = 0.640, p < 0.001), the Acute Physiology And Chronic Health Evaluation II (APACHE II) score (r = 0.539, p < 0.001) and length of hospital stay (r = 0.321, p = 0.011), respectively. In conclusion, plasma YKL-40 may play a role in the diagnosis and clinical assessment of CAP severity, which could potentially guide the development of treatment strategies.

Circulating level of high mobility group box-1 predicts the severity of community-acquired pneumonia: Regulation of inflammatory responses via the c-Jun N-terminal signaling pathway in macrophages

“…The present study demonstrated a correlation between the severity of CAP and HMGB-1 expression. The PSI and CURB-65 criteria have been used to evaluate hospital length of stay and mortality rates of CAP patients for numerous years ( 33 – 35 ). However, these indicators require large amount of clinical data and the collection of excessive data.…”

Serum YKL-40 levels as a prognostic factor in patients with intracerebral hemorrhage

“…Recently, it has been shown that YKL-40 is expressed by monocytes/macrophages in peripheral blood and synovial tissue [27][28][29][30][31]. Although the exact physiological function of YKL-40 is unknown, the results of clinical studies in community-acquired pneumonia, active rheumatoid arthritis, hepatic fibrosis, breast cancer, colorectal cancer, and human glioma have disclosed that serum levels of YKL-40 are correlated with the severity of disease [5][6][7][8][9][10][11][12][13]. Moreover, high levels of YKL-40 in serum and cerebrospinal fluid independently predict death in patients with pneumococcal bacteremia and purulent meningitis, respectively [14,15].…”

“…A positive correlation between the severity of the disease state and the levels of YKL-40 in either cerebrospinal fluid or sera of patients with a variety of pathological conditions has been demonstrated in the recent clinical studies, and most have speculated that YKL-40 might be a valuable biochemical marker of inflammation, similar to C-reactive protein [5][6][7][8][9][10][11][12][13][14][15]. YKL-40 can also be expressed in astrocytes and may take part in acute neuroinflammation [16][17][18].…”

The Clinical Utility of Serum YKL-40 Levels in Community Acquired Pneumonia

“…Diagnostic and prognostic approaches depending on inflammatory biomarkers such as C-reactive protein (CRP), procalcitonin, and cytokines have been further investigated in CAP (7). Promising results have also been obtained by novel biomarkers such as proadrenomedullin, pro-vasopressin, and YKL-40 in daily clinical practice in the management of CAP (7,8). Serum YKL-40 is a glycopeptide largely released from chondrocytes, osteoblasts, macrophages, neutrophils, epithelium and smooth muscle cells, this secretion increasing in systemic inflammation (9)(10)(11).…”