PURPOSE Prognostic biomarkers help triage initial patients and inform targeted therapy selection. Here, we explored the role of progranulin (PGRN)-implicated in processes ranging from inflammation to neurodegeneration-in patients with community-acquired pneumonia (CAP). METHODS A prospective observational cohort study was conducted during 2017. Patients who required invasive mechanical ventilation and/or had septic shock and were discharged from the hospital were cohort II. Those who died at the hospital were cohort III. Remaining patients discharged from the hospital were cohort I. The primary endpoint was that patients progressed to served as cohort II; the secondary endpoint was that patients progressed to served as cohort III. Serum PGRN levels were detected by ELISA. RESULTS A total of 280 patients constituted the study cohort. 194 (69.3%) were categorized into cohort I, 61 (21.8%) were categorized into cohort II, and 25 (8.9%) were categorized into cohort III. Serum PGRN levels were increased in CAP patients, independently of etiology. Adjusting for clinical parameters, the odds ratios (95%CI) of cohort III and combined cohort II-III were 34.968 (3.743-326.692) and 3.741 (1.496-9.351), respectively, comparing lowest-to-highest quartile PGRN levels. PGRN exhibited high accuracy in predicting 30-day mortality, with AUC 0.862. PGRN combined with CURB-65 or PSI significantly improved prediction performance. Cox proportional regression analysis showed PGRN was an independent predictor for 30-day mortality risk. Cox survival curves confirmed PGRN ≥89.51 ng/mL had a significantly higher mortality rate than PGRN <89.51 ng/mL. CONCLUSION Higher PGRN levels at admission were associated with higher odds of poor prognosis. PGRN can improve the prognostic power of CURB-65 or PSI, so PGRN could be apparently a prognostic biomarker for assisting triage of CAP patients.

中文翻译：

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升高的颗粒蛋白原作为一种新的生物标志物，可预测社区获得性肺炎的不良预后。

目的预后生物标志物有助于对初次患者进行分类，并为靶向治疗选择提供依据。在这里，我们探讨了在社区获得性肺炎（CAP）患者中，从炎症到神经退行性变过程中，谷蛋白（PGRN）参与其中的作用。方法2017年进行了一项前瞻性观察队列研究。需要侵入性机械通气和/或脓毒性休克并出院的患者属于队列II。那些在医院死亡的人属于第三代。其余出院的患者属于队列I。主要终点是患者已晋升为队列II。次要终点是患者发展为队列III。通过ELISA检测血清PGRN水平。结果共有280名患者组成了研究队列。194（69。3％的人被归为第一类，61（21.8％）的人被归为第二类，25（8.9％）的人被归为第三类。CAP患者的血清PGRN水平升高，与病因无关。调整临床参数后，比较最低四分位数PGRN到最高四分位数PGRN的水平，队列III和合并队列II-III的优势比（95％CI）分别为34.968（3.743-326.692）和3.741（1.496-9.351）。PGRN在预测30天死亡率方面显示出很高的准确性，AUC为0.862。PGRN与CURB-65或PSI结合可显着提高预测性能。Cox比例回归分析显示PGRN是30天死亡风险的独立预测因子。Cox生存曲线证实PGRN≥89.51ng / mL的死亡率显着高于PGRN <89.51 ng / mL。结论入院时PGRN水平升高与预后差的可能性更高。PGRN可以改善CURB-65或PSI的预后能力，因此PGRN显然可以作为协助CAP患者分诊的预后生物标志物。