NE05 Neurophysin I in community-acquired pneumonia: prognostic value and association with renal function

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Abstract Introduction Neurophysin-I (NP-I) is a surrogate marker of oxytocin (OXT), a hypothalamic hormone with putative anti-inflammatory properties. Purpose We investigated whether NP-I measured at diagnosis could predict adverse outcomes in patients hospitalized with community-acquired pneumonia (CAP). Methods This secondary analysis of the prospective STEP Trial (NCT00973154) included adult patients hospitalized with CAP, normal serum sodium at inclusion, and available baseline blood samples for NP-I measurement. Demographic data, laboratory parameters, and Pneumonia Severity Index (PSI) scores were collected. To ensure representation across disease severity, patients were selected to achieve balanced numbers of low/intermediate-risk (PSI I−III) and high-risk (PSI IV−V) cases. Results Sixty-five patients were included (M/F 38/27 [58.5/41.5%], median age 79 [76−83] years). NP-I levels did not differ between low–intermediate and high-risk groups (p=0.441), between patients with and without CAP-related complications (336 [190−607] vs. 225 [147−539] pM, p=0.326), or between survivors and non-survivors (199 [121−429] vs. 304 [174−604] pM, p=0.259). In univariable logistic regression analysis, PSI was associated with in-hospital mortality (OR 1.027, 95% CI 1.008−1.049, p=0.006), whereas adding NP-I did not improve predictive performance (DeLong’s test p=0.509). Patients with impaired renal function (n=28) had higher NP-I levels than those with preserved renal function (446 [278−685] vs. 182 [124−403] pM, p<0.001). NP-I was independently and inversely associated with eGFR after adjustment for age and sex (β = −9.06, p=0.038). Conclusion NP-I levels are strongly influenced by renal function and do not appear to provide prognostic information for adverse outcomes in patients hospitalized with CAP.

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