The Significance of Defensin Alpha 4 in the Pathophysiology of the Adrenal Insufficiency in Inflammatory Lung Diseases

Cantonal Hospital of St. Gallen75 enrolled

Overview

The pathophysiology of the adrenal insufficiency of patients with critical diseases remains unclear. In a prior exploratory study investigating patients with exacerbation of chronic obstructive pulmonary disease (COPD), the investigators demonstrated a highly significant correlation between the expression level of Defensin-alpha 4 (DEFA4) mRNA in blood and the adrenal function assessed via low-dose ACTH tests. The aim of this prospective study is to demonstrate that DEFA4 measured both at the mRNA level (RT-PCR) and at the protein level (Western blot/Elisa) is a reliable biomarker for the prediction of adrenal insufficiency in inflammatory lung diseases (patients with COPD and pneumonia).

Study Type

OBSERVATIONAL

Enrollment

Conditions

Adrenal Insufficiency Inflammatory Lung Diseases

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 YearsHealthy volunteers:

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Inclusion Criteria: * Patients 18-80 yo * Patients diagnosed with pneumonia or exacerbated COPD * Healthy controls 18-80yo * Signed informed consent Exclusion Criteria: * Pregnant or lactating females * Life threatening severe disease * Known primary or secondary adrenal insufficiency * Systemic steroid therapy in the last 8 weeks * Systemic therapy with opioid * Systemic therapy with Ketoconazol, Mitotane, Metopyron, Etomidat, Rifampicin * In healthy controls: relevant respiratory disease or known adrenal insufficiency or indication of infection * Allergic reaction to ACTH * Missing informed consent