Angiogenic and inflammatory markers in acute respiratory distress syndrome and renal injury associated to A/H1N1 virus infection

• Published in: Experimental and molecular pathology 2013-06, Vol.94 (3), p.486-492
• Main Authors: Bautista, Edgar, Arcos, Magali, Jimenez-Alvarez, Luís, García-Sancho, Ma. Cecilia, Vázquez, María E., Peña, Erika, Higuera, Anjarath, Ramírez, Gustavo, Fernández-Plata, Rosario, Cruz-Lagunas, Alfredo, García-Moreno, Sara A., Urrea, Francisco, Ramírez, Remedios, Correa-Rotter, Ricardo, Pérez-Padilla, José Rogelio, Zúñiga, Joaquín
• Format: Article
• Language: English
• Subjects: A/H1N1; Acute kidney failure; Acute Kidney Injury - metabolism; Acute Kidney Injury - mortality; Acute Kidney Injury - virology; Adult; Angiogenic Proteins - metabolism; ARDS; Biomarkers - metabolism; Chemokine CCL2 - metabolism; Chemokine CXCL10 - metabolism; Chemokines; Female; Humans; Inflammation - metabolism; Influenza A Virus, H1N1 Subtype - isolation & purification; Influenza, Human - complications; Influenza, Human - metabolism; Influenza, Human - mortality; Male; MCP-1; Mexico - epidemiology; Neovascularization, Pathologic - metabolism; Respiratory Distress Syndrome, Adult - metabolism; Respiratory Distress Syndrome, Adult - mortality; Respiratory Distress Syndrome, Adult - virology; Survival Rate; Vascular Endothelial Growth Factor A - metabolism; VEGF
• ISSN: 0014-4800; 1096-0945
• DOI: 10.1016/j.yexmp.2013.03.007

Acute kidney injury (AKI) is often associated to acute respiratory distress syndrome (ARDS) due to influenza A/H1N1 virus infection. The profile of angiogenic and inflammatory factors in ARDS patients may be relevant for AKI. We analyzed the serum levels of several angiogenic factors, cytokines, and chemokines in 32 patients with A/H1N1 virus infection (17 with ARDS/AKI and 15 ARDS patients who did not developed AKI) and in 18 healthy controls. Significantly higher levels of VEGF, MCP-1, IL-6, IL-8 and IP-10 in ARDS/AKI patients were detected. Adjusting by confusing variables, levels of MCP-1 ≥150pg/mL (OR=12.0, p=0.04) and VEGF ≥225pg/mL (OR=6.4, p=0.03) were associated with the development of AKI in ARDS patients. Higher levels of MCP-1 and IP-10 were significantly associated with a higher risk of death in patients with ARDS (hazard ratio (HR)=10.0, p=0.02; HR=25.5, p=0.03, respectively) even taking into account AKI. Patients with influenza A/H1N1 infection and ARDS/AKI have an over-production of MCP-1, VEGF and IP-10 possibly contributing to kidney injury and are associated to a higher risk of death. •AKI is often associated to ARDS due to influenza A/H1N1 virus infection.•We examine levels of inflammatory mediators in blood from patients with ARDS/AKI.•High levels of MCP-1 and VEGF are associated with AKI in ARDS patients.•High levels of MCP-1 and IP-10 are associated with mortality in ARDS patients.