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2016 ; 71
(11
): 1052-1054
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Recovery from pneumonia requires efferocytosis which is impaired in smokers and
those with low body mass index and enhanced by statins
#MMPMID27471049
Wootton DG
; Diggle PJ
; Court J
; Eneje O
; Keogan L
; Macfarlane L
; Wilks S
; Woodhead M
; Gordon SB
Thorax
2016[Nov]; 71
(11
): 1052-1054
PMID27471049
show ga
BACKGROUND: Efferocytosis (the phagocytosis of apoptotic self cells) is a key
mechanism in the resolution of inflammatory processes such as community-acquired
pneumonia (CAP). Efferocytosis therefore represents a modifiable target for
therapy aimed at enhancing intrinsic recovery mechanisms. It is currently not
known which patients recovering from CAP would mostly benefit from a strategy
aimed at enhancing efferocytosis. METHODS: We recruited a cohort of patients with
CAP admitted to a hospital in Liverpool. One month into recovery, subjects were
invited for research bronchoscopy and bronchoalveolar lavage. An ex vivo
efferocytosis assay was performed by challenging alveolar macrophages with
autologous, apoptotic neutrophils. The percentage of alveolar macrophages that
had undergone efferocytosis was determined by flow cytometry. We conducted a
multivariable regression using a linear mixed effects model to determine which
clinical parameters were most closely associated with efferocytosis. RESULTS: We
observed high rates of comorbidity among this CAP cohort. Efferocytosis was
measured in 22 subjects. We assessed multiple combinations of clinical parameters
for association with efferocytosis and found the best-fitting model included an
interaction between smoking status and prior statin use-smoking being associated
with decreased efferocytosis and statin use with increased efferocytosis. These
effects were modified by an association between efferocytosis and body mass index
(BMI), such that as BMI increased so did efferocytosis. CONCLUSIONS: This is the
first study to measure efferocytosis in patients recovering from CAP. The results
suggest that smokers with low BMI have impaired efferocytosis and may benefit
from a statin to boost recovery.
|*Body Mass Index
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Apoptosis/*physiology
[MESH]
|Bronchoalveolar Lavage
[MESH]
|Bronchoscopy
[MESH]
|Community-Acquired Infections/*therapy
[MESH]
|Comorbidity
[MESH]
|England
[MESH]
|Flow Cytometry
[MESH]
|Humans
[MESH]
|Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
[MESH]