Review Article

Biomarkers of Community-Acquired Pneumonia: A Key to Disease Diagnosis and Management

Table 3

Studies addressing acute-phase proteins and signaling molecules for the assessment of CAP severity.

Study [Ref.]Study designPatientsMortality (at 28 days follow-up)
Prediction rules used for assessing the severity of CAP
Target biomarkers

Park et al., 2012
[49]
prospective observational study126
adults
survivors (n = 110),
non-survivors (n = 16)
prediction rules: PSI, CURB65 score, IDSA/ATS guideline
PSI class for Survivors:
I, II and III (n = 70),
IV (n = 28),
V (n = 12)
PSI class for Non-survivors:
I, II and III (n = 1),
IV (n = 4),
V (n = 11)
PCT,
CRP

Kim et al., 2017
[50]
retrospective chart review125
adults
survivors (n = 112), non-survivors (n = 13)
prediction rules: PSI, CURB65 score, IDSA/ATS guideline, APACHE II, SOFA and qSOFA
PSI class for Survivors:
I, II and III (n = 55),
IV or V (n = 57),
PSI class for Non-survivors:
I, II and III (n = 0),
IV or V (n = 13),
PCT,
CRP

Kruger et al., 2008
[51]
multicenter prospective observational study CAPNETZ1671
adults
survivors (n = 1476), non-survivors (n = 70),
lost to follow-up
(n = 125)
CRB-65 score:
0 (n = 557),
1 (n = 608),
2 (n = 275),
3 (n = 58),
4 (n = 10)
PCT,
CRP,
WBC

Que et al., 2015
[52]
retrospective analysis in small cohort77
adults
survivors (n = 65), тon-survivors (n = 12)
APACHE II, median for survivors: 18,
APACHE II, median for non-survivors: 28.5
SAPS II, median for survivors: 42,
SAPS II, median for non-survivors: 59.5
SOFA, median for survivors: 8,
SOFA, median for non-survivors: 13
PCT,
CRP

Haugen et al., 2015
[53]
secondary analysis of data collected in a previously completed randomized double blind, placebo-controlled trial (RCT)430 childrennon-severe CAP (n = 387),
severe CAP (n = 43)
27 cytokines:
IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8/CXCL8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17A, bFGF, eotaxin/CCL11, G-CSF, GM-CSF, IFN-γ, IP-10/ CXCL10, MCP-1/CCL2, MIP-1α/CCL3, MIP-1β/CCL4, RANTES/CCL5, TNF-α, PDGF-BB and VEGF

Wang et al., 2013
[54]
prospective observational study121
adults
CAP patients (n = 61),
healthy controls (n = 60)
prediction rules: PSI, CURB65 score, APACHE II
CRP,
WBC,
YKL-40

Spoorenberg et al., 2018
[55]
secondary analysis of data collected in a previously completed randomized controlled trial (RCT)311
adults
survivors (n =272)
non-survivors (n = 19),
healthy controls (n = 20)
PSI class:
I - III (n = 152),
IV - V (n = 139)
SP-D,
YKL-40,
CCL18,
CA 15-3,
IL-6,
CRP

Wang et al., 2018
[57]
prospective observational study102
adults
mild CAP (n = 36),
severe CAP (n = 35),
healthy controls (n = 31)
prediction rule: CURB-65 score
IRF5,
IFN-a,
IL-6,
IL-10,
IP10,
TNF-a
mRNA levels of IRF5, IL-6, IL-10, IP10, TNF-a, and IFN-a in peripheral blood and bronchoalveolar lavage fluid

Abbreviations:
CURB65 score (confusion, uremia, respiratory rate, blood pressure, age 65 years),
PSI - the pneumonia severity index,
IDSA/ATS guidelines - the Infectious Disease Society of America (IDSA) and the American Thoracic Society (ATS) issued guidelines,
SAPS II - the Simplified Acute Physiology Score II,
APACHE II - the Acute Physiology and Chronic Health Evaluation II score,
SOFA - the Sepsis-related Organ Failure Assessment score,
qSOFA - quick SOFA.