Community-acquired pneumonia : pathogenesis of acute cardiac events and potential adjunctive therapies

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dc.contributor.author Feldman, Charles
dc.contributor.author Anderson, Ronald
dc.date.accessioned 2016-07-18T07:11:20Z
dc.date.issued 2015-08
dc.description.abstract Despite advances in antimicrobial chemotherapy and access to sophisticated intensive care facilities, bacterial community-acquired pneumonia (CAP) continues to carry an unacceptably high mortality rate of 10% to 15% in hospitalized cases. CAP, considered by many to be the most underestimated disease worldwide, poses a particular threat to the elderly whose numbers are steadily increasing in developed countries. Indeed, elderly patients with severe CAP, as well as those with other risk factors, are at significant risk for development of inflammation-mediated acute cardiac events that may undermine the success of antimicrobial therapy. Adjunctive antiinflammatory strategies are, therefore, of considerable potential benefit in this setting. Currently, the most promising of these are the macrolides, corticosteroids, and, more recently, statins, all of which target immune/inflammatory cells. In addition, recent insights into the immunopathogenesis of acute coronary events in patients with CAP have revealed a probable pivotal role of platelet activation, potentially modifiable by agents that possess antiinflammatory or platelet-targeted activities or both. Statins, which not only possess antiinflammatory activity but also appear to target several pathways involved in platelet activation, seem particularly well suited as adjuncts to antibiotic therapy in bacterial CAP. Following a brief consideration of the immunopathogenesis of bacterial CAP, this review is focused on mechanisms of platelet activation by CAP pathogens, as well as the pharmacologic control thereof, with emphasis on statins. en_ZA
dc.description.department Immunology en_ZA
dc.description.embargo 2016-08-31
dc.description.librarian hb2016 en_ZA
dc.description.sponsorship National Research Foundation (SA). en_ZA
dc.description.uri http://www.journals.elsevier.com/chest en_ZA
dc.identifier.citation Feldman, C & Anderson, R 2015, 'Community-acquired pneumonia : pathogenesis of acute cardiac events and potential adjunctive therapies', Chest, vol. 148, no. 2, pp. 523-532. en_ZA
dc.identifier.issn 0012-3692 (print)
dc.identifier.issn 1931-3543 (online)
dc.identifier.other 10.1378/chest.15-0484
dc.identifier.uri http://hdl.handle.net/2263/55845
dc.language.iso en en_ZA
dc.publisher Elsevier en_ZA
dc.rights © 2015 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in Chest. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Chest, vol. 148, no. 2, pp. 523-532, 2015. doi : 10.1378/chest.15-0484. en_ZA
dc.subject Pneumonia en_ZA
dc.subject Pathogenesis en_ZA
dc.subject Acute cardiac events en_ZA
dc.subject Potential adjunctive therapies en_ZA
dc.title Community-acquired pneumonia : pathogenesis of acute cardiac events and potential adjunctive therapies en_ZA
dc.type Postprint Article en_ZA


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