AUTHOR=Jiang Ya-Lin , Liu Hong-Yan , Tang Min-Min , Cheng Jia-Yi , Zhao Hui , Fu Lin 

TITLE=Serum Level of 4-Hydroxynonenal in Community-Acquired Pneumonia: A Potential Biomarker for Severity and Prognosis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.798343

DOI=10.3389/fmed.2022.798343

ISSN=2296-858X

ABSTRACT=Background: 4-Hydroxynonenal (4-HNE) exerts central roles in the pathophysiological process of pulmonary diseases. The aim of this project was to evaluate the correlations between serum 4-HNE with severity and prognosis in community-acquired pneumonia (CAP) patients by a prospective cohort study.
Methods: All 239 CAP patients and healthy volunteers were recruited. Fasting blood was collected. Serum 4-HNE was measured with ELISA. Clinical characteristics and demographic information were obtained. The relationships between serum 4-HNE and clinical characteristics were evaluated though Spearman or Pearson correlation coefficient. The associations of serum 4-HNE with severity and prognosis were estimated through logistic regression analysis.  
Results: On admission, serum 4-HNE was upregulated in CAP patients compared with healthy volunteers. Serum 4-HNE was gradually elevated in line with CAP scores. Additionally, elderly CAP patents were more prone to suffer from 4-HNE elevation. Moreover, serum 4-HNE was positively correlated with CAP severity scores. Meanwhile, the poor prognostic outcomes were tracked among CAP patients. Higher serum 4-HNE on admission increased the risks of mechanical ventilation, vasoactive agent suage and death in CAP patients during hospitalization. The predictive powers for severity and death were elevated in serum 4-HNE compared with CAP severity scores and inflammatory cytokines. 
Conclusion: Serum 4-HNE on admission is positively correlated with the severity and poor prognosis among CAP patients, indicating that 4-HNE participates in the pathophysiology of CAP. Serum 4-HNE may be used as an earlier biomarker for diagnosis and prognosis in CAP patients.