{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:11:35Z","timestamp":1789992695722,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T00:00:00Z","timestamp":1468281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Community\u2010acquired pneumonia (<jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content>) is associated with an increased risk of arterial and venous thrombosis but the underlying pathophysiological mechanisms are still unclear. We investigated if, in patients with <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content>, a pro\u2010thrombotic state does exist and its relationship with serum levels of endotoxins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 104 consecutive patients with <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> were prospectively recruited and followed up until discharge. At admission and at discharge, serum endotoxins, systemic markers of clotting activation and zonulin, a marker of gut permeability, were analysed. Hospitalized patients matched for gender, age and comorbidities but without infections were used as control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At admission, <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> patients showed higher plasma levels of <jats:styled-content style=\"fixed-case\">F<jats:sub>1<\/jats:sub>\n<\/jats:styled-content>\n<jats:sub>+2<\/jats:sub>, a marker of thrombin generation (<jats:italic>P<\/jats:italic>\u2009=\u20090.023), and lower levels of protein C (<jats:styled-content style=\"fixed-case\">PC<\/jats:styled-content>; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and activated <jats:styled-content style=\"fixed-case\">PC<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">aPC<\/jats:styled-content>) (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) compared with controls. At discharge, plasma levels of both <jats:styled-content style=\"fixed-case\">PC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">aPC<\/jats:styled-content> significantly increased while <jats:styled-content style=\"fixed-case\">F<jats:sub>1<\/jats:sub>\n<\/jats:styled-content>\n<jats:sub>+2<\/jats:sub> significantly decreased (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Baseline serum endotoxins and zonulin were higher in <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> patients than controls (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and significantly decreased at discharge; a significant correlation between serum endotoxins and zonulin was detected (R\u2009=\u20090.575; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001)<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides the first evidence that <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content> patients disclose an ongoing pro\u2010thrombotic state and suggests a role for endotoxemia in determining enhanced thrombin generation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.12854","type":"journal-article","created":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T13:24:33Z","timestamp":1468329873000},"page":"1465-1471","source":"Crossref","is-referenced-by-count":32,"title":["Low\u2010grade endotoxemia and clotting activation in the early phase of pneumonia"],"prefix":"10.1111","volume":"21","author":[{"given":"Roberto","family":"Cangemi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Della Valle","sequence":"additional","affiliation":[{"name":"Coagulation Service &amp; Thrombosis Research Unit Scientific Institute San Raffaele  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Calvieri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Taliani","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Department of Clinical Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Ferroni","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Advanced Biotechnologies IRCCS San Raffaele Pisana  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Falcone","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Carnevale","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Bartimoccia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"D'Angelo","sequence":"additional","affiliation":[{"name":"Coagulation Service &amp; Thrombosis Research Unit Scientific Institute San Raffaele  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Violi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"in collaboration with the SIXTUS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.259"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61266-5"},{"key":"e_1_2_7_4_1","unstructured":"CangemiR CasciaroM RossiE CalvieriC BucciT CalabreseCM TalianiG FalconeM PalangeP BertazzoniGet al.SIXTUS Study Group. 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