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Serum type III procollagen peptide in patients with Pneumocystis carinii infection. The Copenhagen-Amsterdam PCP-Prednisolone Study Group.
Am Rev Respir Dis. 1993 Dec; 148(6 Pt 1):1558-62.AR

Abstract

Inflammation may play a central role in the pathogenesis of HIV-related Pneumocystis carinii pneumonia (PCP). Serum levels of the amino-terminal propeptide of Type III procollagen (PIIINP) reflect inflammatory activity in granulation tissue and in chronic rheumatic and liver disorders. To investigate changes in PIIINP serum levels during an episode of HIV-related PCP, consecutive serum samples were taken from 48 HIV-infected patients with PCP in a randomized, placebo-controlled study of the effect of adjunctive methylprednisolone therapy (26 in corticosteroid [CS] group and 22 in control group). All patients were treated with co-trimoxazole. In the control group, PIIINP serum levels at day of initiation of therapy (Day 0) were significantly higher in patients requiring mechanical ventilation and/or dying during the course of the pneumonia, and serum levels of PIIINP higher than 5 ng/ml were associated with a higher mortality than levels below 5 ng/ml. The level of PIIINP increased from Day 0 to Day 5. There was a significant correlation between changes in PIIINP levels and changes in the alveolar-arterial oxygen gradient from Day 0 to Day 5. In the CS group, the PIIINP levels decreased while steroid was administered. At Days 21 to 28 there were no difference in the levels of PIIINP between the two groups. PIIINP serum levels may predict the clinical outcome of PCP. The antimicrobial therapy may exacerbate the inflammatory reaction in HIV-related PCP, leading to respiratory failure. CS prevents this increased inflammatory activity.

Authors+Show Affiliations

Department of Infectious Diseases and of Rheumatology, Hvidovre Hospital, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

8256900

Citation

Bentsen, K D., et al. "Serum Type III Procollagen Peptide in Patients With Pneumocystis Carinii Infection. the Copenhagen-Amsterdam PCP-Prednisolone Study Group." The American Review of Respiratory Disease, vol. 148, no. 6 Pt 1, 1993, pp. 1558-62.
Bentsen KD, Nielsen TL, Eaftinck Schattenkerk JK, et al. Serum type III procollagen peptide in patients with Pneumocystis carinii infection. The Copenhagen-Amsterdam PCP-Prednisolone Study Group. Am Rev Respir Dis. 1993;148(6 Pt 1):1558-62.
Bentsen, K. D., Nielsen, T. L., Eaftinck Schattenkerk, J. K., Jensen, B. N., & Lundgren, J. D. (1993). Serum type III procollagen peptide in patients with Pneumocystis carinii infection. The Copenhagen-Amsterdam PCP-Prednisolone Study Group. The American Review of Respiratory Disease, 148(6 Pt 1), 1558-62.
Bentsen KD, et al. Serum Type III Procollagen Peptide in Patients With Pneumocystis Carinii Infection. the Copenhagen-Amsterdam PCP-Prednisolone Study Group. Am Rev Respir Dis. 1993;148(6 Pt 1):1558-62. PubMed PMID: 8256900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum type III procollagen peptide in patients with Pneumocystis carinii infection. The Copenhagen-Amsterdam PCP-Prednisolone Study Group. AU - Bentsen,K D, AU - Nielsen,T L, AU - Eaftinck Schattenkerk,J K, AU - Jensen,B N, AU - Lundgren,J D, PY - 1993/12/1/pubmed PY - 1993/12/1/medline PY - 1993/12/1/entrez SP - 1558 EP - 62 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 148 IS - 6 Pt 1 N2 - Inflammation may play a central role in the pathogenesis of HIV-related Pneumocystis carinii pneumonia (PCP). Serum levels of the amino-terminal propeptide of Type III procollagen (PIIINP) reflect inflammatory activity in granulation tissue and in chronic rheumatic and liver disorders. To investigate changes in PIIINP serum levels during an episode of HIV-related PCP, consecutive serum samples were taken from 48 HIV-infected patients with PCP in a randomized, placebo-controlled study of the effect of adjunctive methylprednisolone therapy (26 in corticosteroid [CS] group and 22 in control group). All patients were treated with co-trimoxazole. In the control group, PIIINP serum levels at day of initiation of therapy (Day 0) were significantly higher in patients requiring mechanical ventilation and/or dying during the course of the pneumonia, and serum levels of PIIINP higher than 5 ng/ml were associated with a higher mortality than levels below 5 ng/ml. The level of PIIINP increased from Day 0 to Day 5. There was a significant correlation between changes in PIIINP levels and changes in the alveolar-arterial oxygen gradient from Day 0 to Day 5. In the CS group, the PIIINP levels decreased while steroid was administered. At Days 21 to 28 there were no difference in the levels of PIIINP between the two groups. PIIINP serum levels may predict the clinical outcome of PCP. The antimicrobial therapy may exacerbate the inflammatory reaction in HIV-related PCP, leading to respiratory failure. CS prevents this increased inflammatory activity. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/8256900/Serum_type_III_procollagen_peptide_in_patients_with_Pneumocystis_carinii_infection._The_Copenhagen-Amsterdam_PCP-Prednisolone_Study_Group. L2 - https://www.atsjournals.org/doi/10.1164/ajrccm/148.6_Pt_1.1558?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -