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RESEARCH PRODUCT

Circulating microRNAs can identify endotypes of community-acquired pneumonia

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Background: The identification of the host processes dysregulated in community-acquired pneumonia (CAP) patients, especially in those who develop severe complications could be crucial for future management of this disease. We aim to study microRNAs profiles to define different CAP endotypes regarding complications. Methods: An observational prospective study of consecutive hospitalized CAP cases was performed. Circulating microRNAs were analyzed using qRT-PCR. We study correlations and predictive value of miRNAs regarding severe sepsis and acute hypoxemic respiratory failure (AHRF: PaO2/FiO2 Results: We analyzed clinical data and blood samples from 169 CAP patients. The mean age was 66.9 years (IQR: 58-79). The main comorbidities were diabetes (29%), COPD (28.4%), arrhythmia (13.6%), and cerebrovascular disease (8.9%). 97 patients (57.4%) presented severe CAP (PSI IV-V). Complications were found in 109 patients (64.5%): AHRF was present in 25.4%, and severe sepsis in 13.6%. Mortality was 3.6%. We found that miR 223 and miR 574 were downregulated in severe sepsis (AUC 0.78), and in AHRF (AUC 0.77) respectively. miR 182 downregulation had a high predictive value to predict both severe sepsis and AHRF (AUC 0.83 and 0.76) in hospitalized CAP patients. Conclusions: 1-We have identified different endotypes in CAP determined by circulating miRNAs profiles. 2-The expression of miR-223, miR-574, and miR-182 are related to severe sepsis and AHRF in hospitalized CAP patients. Funded by: Sociedad Valenciana de Neumologia