Recovery from pneumonia requires efferocytosis which is impaired in smokers and those with low body mass index and enhanced by statins.

Wootton, Daniel G, Diggle, Peter J, Court, Joanne, Eneje, Odiri, Keogan, Lynne, Macfarlane, Laura, Wilks, Sarah, Woodhead, Mark and Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116 (2016) 'Recovery from pneumonia requires efferocytosis which is impaired in smokers and those with low body mass index and enhanced by statins.'. Thorax, Vol 71, Issue 11, pp. 1052-1054.

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Abstract

BACKGROUND
Efferocytosis (the phagocytosis of apoptotic self cells) is a key mechanism in the resolution of inflammatory processes such as community-acquired pneumonia (CAP). Efferocytosis therefore represents a modifiable target for therapy aimed at enhancing intrinsic recovery mechanisms. It is currently not known which patients recovering from CAP would mostly benefit from a strategy aimed at enhancing efferocytosis.

METHODS
We recruited a cohort of patients with CAP admitted to a hospital in Liverpool. One month into recovery, subjects were invited for research bronchoscopy and bronchoalveolar lavage. An ex vivo efferocytosis assay was performed by challenging alveolar macrophages with autologous, apoptotic neutrophils. The percentage of alveolar macrophages that had undergone efferocytosis was determined by flow cytometry. We conducted a multivariable regression using a linear mixed effects model to determine which clinical parameters were most closely associated with efferocytosis.

RESULTS
We observed high rates of comorbidity among this CAP cohort. Efferocytosis was measured in 22 subjects. We assessed multiple combinations of clinical parameters for association with efferocytosis and found the best-fitting model included an interaction between smoking status and prior statin use-smoking being associated with decreased efferocytosis and statin use with increased efferocytosis. These effects were modified by an association between efferocytosis and body mass index (BMI), such that as BMI increased so did efferocytosis.

CONCLUSIONS
This is the first study to measure efferocytosis in patients recovering from CAP. The results suggest that smokers with low BMI have impaired efferocytosis and may benefit from a statin to boost recovery.

Item Type:	Article
Subjects:	WA Public Health > Air pollution > WA 754 Pollution and pollutants (incl. tobacco pollution; passive smoking) WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified) WF Respiratory System > WF 140 Diseases of the respiratory system (General)
Digital Object Identifer (DOI):	https://doi.org/10.1136/thoraxjnl-2016-208505
Depositing User:	Jessica Jones
Date Deposited:	25 Aug 2016 10:06
Last Modified:	07 Jun 2022 11:10
URI:	https://archive.lstmed.ac.uk/id/eprint/6086

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