S-Adenosylmethionine Levels in the Diagnosis of Pneumocystis carinii Pneumonia in Patients with HIV Infection

Background.S-adenosylmethionine (AdoMet) is a key molecule involved in methylation reactions and polyamine synthesis. Pneumocystis carinii are unable to synthesize this molecule and have been shown to scavenge this metabolic intermediate from the plasma of rats during active infection. A prior study...

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Bibliographic Details
Published in:Clinical infectious diseases 2008-02, Vol.46 (3), p.467-471
Main Authors: Skelly, Michael J., Holzman, Robert S., Merali, Salim
Format: Article
Language:English
Subjects:
Adult
Bacterial pneumonia
Biological and medical sciences
Blood plasma
Fever
HIV infections
HIV Infections - blood
HIV Infections - microbiology
HIV/AIDS
Hospital admissions
Human mycoses
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Infectious diseases
Medical sciences
Mycoses
Mycoses of the respiratory system
Patient assessment
Pneumocystis carinii
Pneumocystis carinii - isolation & purification
Pneumocystis pneumonia
Pneumonia, Pneumocystis - blood
Pneumonia, Pneumocystis - virology
Prospective Studies
S-Adenosylmethionine - blood
Tuberculosis, Pulmonary - blood
Tuberculosis, Pulmonary - virology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Background.S-adenosylmethionine (AdoMet) is a key molecule involved in methylation reactions and polyamine synthesis. Pneumocystis carinii are unable to synthesize this molecule and have been shown to scavenge this metabolic intermediate from the plasma of rats during active infection. A prior study involving humans strongly suggested that low levels of plasma AdoMet are sensitive and specific indicators of acute infection. Methods.From March 2004 through January 2006, we collected plasma AdoMet levels from patients with human immunodeficiency virus (HIV) infection and either confirmed Pneumocystis carinii pneumonia (PCP), confirmed pulmonary tuberculosis, or confirmed bacterial pneumonia. We compared levels in patients with PCP with those in patients with other diseases and also monitored changes in levels during treatment of PCP. Results.Initial AdoMet levels were significantly lower in patients with PCP, and there was no overlap between the groups. Among patients with PCP, levels of AdoMet increased with successful treatment. Conclusions.Measurement of plasma AdoMet levels in patients with HIV infection who have pulmonary infections can identify those with PCP.
ISSN:1058-4838
1537-6591
DOI:10.1086/525854