Usefulness of plasma YKL-40 in management of community-acquired pneumonia severity in patients

Abstract

Plasma YKL-40 level has been reported as playing a significant role in community-acquired pneumonia (CAP). However, the correlation between plasma level of YKL-40 and the severity of CAP has not been reported. This study identifies the relationship between plasma level changes of the YKL-40 gene in adult patients hospitalized with CAP. The ELISA was used to measure the plasma YKL-40 level from 61 adult CAP patients before and after antibiotic treatment and from 60 healthy controls. The plasma YKL-40 levels were significantly increased in patients with CAP compared to normal controls. Moreover, the plasma concentration of YKL-40 correlated with the severity of CAP based on the pneumonia severity index (PSI) score (r = 0.630, p < 0.001), the CURB-65 (confusion, uremia, respiratory rate, BP, age 65 years) score (r = 0.640, p < 0.001), the Acute Physiology And Chronic Health Evaluation II (APACHE II) score (r = 0.539, p < 0.001) and length of hospital stay (r = 0.321, p = 0.011), respectively. In conclusion, plasma YKL-40 may play a role in the diagnosis and clinical assessment of CAP severity, which could potentially guide the development of treatment strategies.

Figure 1

Levels of plasma YKL-40 in 61 patients with community-acquired pneumonia and 60 control patients based on ELISA analysis.

Figure 2

Analysis of the correlation between YKL-40 expression with PSI, CURB-65, APACHE II scores and hospital length of stay. Before treatment, CAP patients exhibited correlations among PSI, CURB-65, APACHE II scores, hospital length of stay and YKL-40 expression. There were significant correlations between YKL-40 and PSI (Spearman correlation coefficients r = 0.630, p < 0.001, n = 61; (A) CURB-65 (Spearman correlation coefficients r = 0.640, p < 0.001, n = 61; (B) APACHE II (Spearman correlation coefficients r = 0.539, p < 0.001, n = 61; (C) and hospital length of stay (Spearman correlation coefficient r = 0.321, p=0.011, n = 61; (D) in CAP patients before they received treatment.