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<p>Alpha-1 antitrypsin (α<sub>1</sub>-AT), an acute-phase protein, demonstrates anti-inflammatory, antiviral, and immunomodulatory properties. The early detection of disease severity and pathogen in community-acquired pneumonia (CAP) is crucial for patient management. The role of α<sub>1</sub>-AT in this context has not been fully elucidated. Our study compared plasma α<sub>1</sub>-AT levels between 74 CAP patients and 86 healthy controls. We measured plasma α<sub>1</sub>-AT concentrations via ELISA, assessed disease severity using CURB-65, CRB-65, and SMART-COP scores, and analyzed correlations between α<sub>1</sub>-AT levels with inflammatory markers, disease severity, and pathogen subtypes. Our findings revealed that plasma α<sub>1</sub>-AT was higher in CAP patients than in controls (<i>p</i> &lt; 0.0001) and correlated positively with IL-6 and TNF-α. In addition, α<sub>1</sub>-AT concentrations increased with CAP severity and were positively correlated with CURB-65, CRB-65, and SMART-COP scores. Exploratory analyses revealed elevated α<sub>1</sub>-AT in Gram-positive bacterial and mycoplasma infections, with high predictive value for Gram-positive cases (AUC 0.9479; 95% CI 0.8997–0.9961). These findings suggest α<sub>1</sub>-AT as a potential adjunctive biomarker for assessing inflammation and disease severity in CAP, while its role in pathogen discrimination requires validation in larger cohorts.</p>

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Alpha-1 antitrypsin as a new biomarker of inflammation, infection and disease severity in community-acquired pneumonia: a prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月8日

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  • Siqing Huang,
  • Shuna Wei,
  • Fang Luo,
  • Yuanxiong Cheng

摘要

Alpha-1 antitrypsin (α1-AT), an acute-phase protein, demonstrates anti-inflammatory, antiviral, and immunomodulatory properties. The early detection of disease severity and pathogen in community-acquired pneumonia (CAP) is crucial for patient management. The role of α1-AT in this context has not been fully elucidated. Our study compared plasma α1-AT levels between 74 CAP patients and 86 healthy controls. We measured plasma α1-AT concentrations via ELISA, assessed disease severity using CURB-65, CRB-65, and SMART-COP scores, and analyzed correlations between α1-AT levels with inflammatory markers, disease severity, and pathogen subtypes. Our findings revealed that plasma α1-AT was higher in CAP patients than in controls (p < 0.0001) and correlated positively with IL-6 and TNF-α. In addition, α1-AT concentrations increased with CAP severity and were positively correlated with CURB-65, CRB-65, and SMART-COP scores. Exploratory analyses revealed elevated α1-AT in Gram-positive bacterial and mycoplasma infections, with high predictive value for Gram-positive cases (AUC 0.9479; 95% CI 0.8997–0.9961). These findings suggest α1-AT as a potential adjunctive biomarker for assessing inflammation and disease severity in CAP, while its role in pathogen discrimination requires validation in larger cohorts.