Using Routine Laboratory Markers and Immunological Indicators for Predicting Pneumocystis jiroveci Pneumonia in Immunocompromised Patients

Tang, Guoqing; Tong, Shutao; Xu, Yuan; Lin, Qun; Luo, Ying; Song, Huijuan; Liu, Wei; Wu, Shiji; L, Mao; Liu, Weiyong; Zhu, Yaowu; Sun, Ziyong; Wang, Feng

doi:10.3389/fimmu.2021.652383

Cited by 21 publications

(18 citation statements)

References 41 publications

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“…Consistent with previous study, we showed that LDH in the PCP group was significantly higher than that in the non-PCP group, which could be due to the lung injury. 17 However, we showed that there was no significant difference in the counts of total lymphocytes, CD3+ lymphocytes, and CD8+ lymphocytes between PCP and non-PCP groups. In contrast, we observed that patients with PCP were associated with a significant decrease of CD4+ T cells in blood and CD4+/CD8+ ratio in both circulation and BAL.…”

Section: Discussionmentioning

confidence: 58%

“…Consistent with previous study, we showed that LDH in the PCP group was significantly higher than that in the non-PCP group, which could be due to the lung injury. 17 However, we showed that there was no significant difference in the counts of total lymphocytes, CD3+ lymphocytes, and Tang et al 17 showed that both CD4+ and CD8+ cells were decreased in non-HIV PCP patients. Ling et al showed that a decrease in CD4+/CD8+ ratio could predict PCP in non-HIV children.…”

Section: Discussionmentioning

confidence: 74%

“…Li et al 19 revealed a lower level of CD8+ cell counts in the PCP group. Tang et al 17 showed that both CD4+ and CD8+ cells were decreased in non-HIV PCP patients. Ling et al showed that a decrease in CD4+/CD8+ ratio could predict PCP in non-HIV children.…”

Section: Discussionmentioning

confidence: 99%

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Supplementary Role of Immunological Indicators in the Diagnosis and Prognosis of Pneumocystis Pneumonia in Non-HIV Immunocompromised Patients

Cao¹,

Chen²,

Dong³

2022

IDR

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Background Pneumocystis pneumonia (PCP) has a high mortality in HIV-negative immunocompromised patients. The occurrence and development of PCP are believed to be correlated with the level of lymphocytes and their subsets. The aim of this study was to determine if the levels of lymphocyte subpopulations and immunoglobulin are associated with PCP. Methods A total of 74 immunocompromised patients were enrolled in this single-center cohort study. Diagnosis of PCP was based on the relevant pulmonary symptoms and radiological imaging, and the detection of Pneumocystis jirovecii in BAL fluid or biopsy tissue by metagenomic next-generation sequencing (mNGS). All patients were divided into two groups (PCP group and non-PCP group) and the patients in PCP group were then divided into two groupsbased on the outcome of the disease during the hospitalization. Results We observed a significant lower level of IgG ( p =0.000) and B lymphocyte counts ( p =0.017) in the PCP group comparing to that in the non-PCP group. CD4+ T cell counts, as well as the ratio of CD4+/CD8+ T cells in circulation and BAL fluid were also lower in the PCP group comparing to those in the non-PCP group. Lactate dehydrogenase (LDH) in the PCP group was significantly higher than that in the non-PCP group ( p =0.029). In the PCP group, a lower level of total lymphocytes ( p =0.004), T cells ( p =0.001), CD4+ cells ( p =0.001), and CD8+ cells ( p =0.007), as well as the proportion of lymphocytes in BAL fluid ( p =0.000) were found in deceased patients comparing to those in the survived group. Conclusion Our study revealed an important role of humoral immunity in the infection of Pneumocystis jirovecii . The level of B cells and IgG could be used as a supplement to predict the occurrence of PCP. The level of CD4+ and CD8+ lymphocytes was significantly correlated with the outcome of PCP.

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Section: Discussionmentioning

confidence: 58%

“…Consistent with previous study, we showed that LDH in the PCP group was significantly higher than that in the non-PCP group, which could be due to the lung injury. 17 However, we showed that there was no significant difference in the counts of total lymphocytes, CD3+ lymphocytes, and Tang et al 17 showed that both CD4+ and CD8+ cells were decreased in non-HIV PCP patients. Ling et al showed that a decrease in CD4+/CD8+ ratio could predict PCP in non-HIV children.…”

Section: Discussionmentioning

confidence: 74%

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Supplementary Role of Immunological Indicators in the Diagnosis and Prognosis of Pneumocystis Pneumonia in Non-HIV Immunocompromised Patients

Cao¹,

Chen²,

Dong³

2022

IDR

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“…Additionally, lactate dehydrogenase (LDH) is an important predictive marker for patients with PJP. LDH in patients with PJP was significantly higher than in non-PJP controls ( 27 ). Neutropenia is a risk factor of PJP.…”

Section: Discussionmentioning

confidence: 83%

Pneumocystis Jirovecii Pneumonia Diagnosis via Metagenomic Next-Generation Sequencing

Zhang

et al. 2022

Front. Med.

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The incidence of non-HIV-infected Pneumocystis Jirovecii Pneumonia (PJP) is increasing. The prognosis for non-HIV PJP is poor and diagnostic tests are of lower sensitivity in non-HIV patients. Metagenomic next-generation sequencing (mNGS) was compared with routine detection assays, including Gomori methenamine silver (GMS) stain and polymerase chain reaction (PCR) technique. Specimens of 4 bronchoalveolar lavages (BAL) and 1 lung tissue samples were obtained from 4 non-HIV patients from our hospitals. Although both GMS and mNGS were positive for P. jirovecii with PCR as positive control, the testing time of mNGS was obviously shorter than GMS. Compared with the traditional GMS method, mNGS has absolute advantages. However, the issue with PJP presentations having atypical symptoms and ambiguous imaging features persists. Hence, the disease can easily be ignored. Secondly, PJP progresses rapidly in non-HIV-infected patients and can cause severe respiratory failure with unfavorable prognosis. This study affirms that mNGS can be used to quickly and accurately diagnose PJP, but a combination of clinical judgement of symptoms, laboratory testing, and imaging examination is required to make a comprehensive judgment along with mNGS test results.

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“…Recently, many studies manifested that the blood routine parameters and the rate between them may use as indicators for state, development, and prognosis of diseases ( 32 , 33 ). AS is a common chronic rheumatic disease, and we systematically determined the relevance between new-onset AS and blood routine parameters (WBC, L, L%, N, N%, M, M%, PLT, MPV, PCT, PDW, RBC, HGB, and HCT) and the ratio between them (LMR, PLR, NLR, dNLR, PMR, MNR, PNR, and SII).…”

Section: Discussionmentioning

confidence: 99%

Expression and Clinical Significance of the m6A RNA-Binding Proteins YTHDF2 in Peripheral Blood Mononuclear Cells From New-Onset Ankylosing Spondylitis

et al. 2022

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This study has focused on determining the association of m6A methyltransferase [methyltransferase-like 3 (METTL3), methyltransferase-like 14 (METTL14), and Wilms tumor 1-associating protein (WTAP)], demethylase [fat mass and obesity-associated protein (FTO) and alkylation repair homolog protein 5 (ALKBH5)], RNA-binding proteins [YT521-B homology domains 2 (YTHDF2)], and ankylosing spondylitis (AS). A total of 154 specimens, containing 79 patients with new-onset AS and 75 healthy controls (HCs), participated in the study. The mRNA expressions of these m6A methyltransferase, demethylase, and RNA-binding protein in peripheral blood mononuclear cells (PBMCs) were detected by quantitative real-time PCR (qRT-PCR). The data showed that the mRNA expressions of YTHDF2 and ALKBH5 in PBMC from patients with new-onset AS were significantly decreased, and there was a positive correlation between RNA-binding proteins (YTHDF2) and demethylase (ALKBH5) in patients with new-onset AS. Logistic regression analysis demonstrated that the expression of YTHDF2 mRNA in PBMC is a risk factor of AS. Receiver operating characteristic (ROC) analysis of the area under the curve (AUC) for mRNA YTHDF2 in new-onset AS and HC was 0.692, with a cutoff value of <0.8724, a sensitivity of 67%, and a specificity of 63%. Moreover, we constructed a novel predictive model based on a combination of mRNA YTHDF2 and systemic immune-inflammation index (SII) for AS diagnosis (AUC = 0.865, sensitivity = 79.45%, specificity = 84.00%), and the predictive model correlated with the activity and severity of AS. This study indicates that the mRNA expression of YTHDF2 in PBMC may be involved in AS pathogenesis and a predictive model based on a combination of mRNA YTHDF2 and SII acts as a marker for diagnosis and progression of diseases.

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Using Routine Laboratory Markers and Immunological Indicators for Predicting Pneumocystis jiroveci Pneumonia in Immunocompromised Patients

Cited by 21 publications

References 41 publications

Supplementary Role of Immunological Indicators in the Diagnosis and Prognosis of Pneumocystis Pneumonia in Non-HIV Immunocompromised Patients

Supplementary Role of Immunological Indicators in the Diagnosis and Prognosis of Pneumocystis Pneumonia in Non-HIV Immunocompromised Patients

Pneumocystis Jirovecii Pneumonia Diagnosis via Metagenomic Next-Generation Sequencing

Expression and Clinical Significance of the m6A RNA-Binding Proteins YTHDF2 in Peripheral Blood Mononuclear Cells From New-Onset Ankylosing Spondylitis

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