Evidence map›Paper›PMID 41632347›Full record

ArticleIntensive care medicine experimental2026

Microbial lung-to-blood translocation associates with systemic inflammation in severe pneumonia: evidence from paired plasma and lower respiratory tract metagenomics.

Haopu Yang, Matthew K Hensley, Vi D-B Nguyen, Nameer S Al-Yousif, Noel Britton, Ghady Haidar, Libing Yang, Faraaz Shah, William Bain, Xiaohong Wang and 12 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Intensive care medicine experimental, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Haopu Yang *Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Matthew K Hensley *Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Vi D-B NguyenDepartment of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, 91342, USA.
Nameer S Al-YousifDepartment of Medicine, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA, 15219, USA.
Noel BrittonCenter for Shock, Trauma and Anesthesiology Research, Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
Ghady HaidarDepartment of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
Libing YangDepartment of Thoracic Surgery, Peking Union Medical College Hospital, Beijing, 100730, China.
Faraaz ShahDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
William BainDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Xiaohong WangDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Shulin QinDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Asim A AhmedKarius Inc, Redwood City, CA, 94065, USA.
Tim BlauwkampKarius Inc, Redwood City, CA, 94065, USA.
Sivan BercoviciKarius Inc, Redwood City, CA, 94065, USA.
Brett A KaufmanHeart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
Kevin M ReddingHeart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
Adam FitchDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Barbara MethéDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Panayiotis V BenosDepartment of Epidemiology, University of Florida, Gainesville, FL, 32603, USA.
Bryan J McVerryVeterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, 15240, USA.
Alison MorrisRutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, 07103, USA.
Georgios D KitsiosDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA. kitsiosg@upmc.edu.ORCID http://orcid.org/0000-0002-1018-948X

Funding

Regulation of Cardiolin Byosynthesis in Epithelial InjuryP01HL114453 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MALLAMPALLI, RAMA K · 2014 to 2023
$21.3M
Airspace Candida Colonization and Lung Injury (AirCCoLIN)R01HL176668 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Georgios Kitsios · 2025 to 2026
$1.4M
NHLBI NIH HHS P01 HL 114453NHLBI NIH HHS P01 HL114453NHLBI NIH HHS R01 HL176668NHLBI NIH HHS R01HL176668
6 · The paper itself

Abstract

backgroundBiological heterogeneity in host inflammatory responses to severe pneumonia predicts clinical outcomes and may influence the effectiveness of immunomodulatory therapy. The upstream drivers of this heterogeneity remain poorly defined. We hypothesized that microbial translocation from the lungs to the bloodstream, detectable via multi-compartment metagenomic analysis, contributes to divergent host responses in pneumonia.

methodsIn this nested case-control study of mechanically ventilated patients with severe pneumonia, we collected paired plasma and endotracheal aspirate samples at baseline. Plasma samples underwent microbial cell-free DNA (mcfDNA) sequencing, and endotracheal aspirates were analyzed by Nanopore metagenomic sequencing. Host-response biomarkers were measured in both plasma and endotracheal aspirate samples. Microbial translocation of pulmonary origin was defined by the genus-level concordance of detectable taxa between matched endotracheal aspirate and plasma samples.

resultsAmong 98 patients (76 pneumonia, 22 controls), plasma mcfDNA was markedly higher in microbiologically confirmed pneumonia compared with culture-negative pneumonia (median 4015 vs. 210 molecules/μL, p = 0.0006). Pulmonary microbial translocation was identified in 31 (41%) pneumonia patients and correlated significantly with plasma soluble ST2 levels, independent of clinical severity. Patients classified into the prognostically adverse hyperinflammatory subphenotype exhibited greater translocating microbial DNA levels compared to hypoinflammatory patients (p = 0.04), further linking translocation to host-response heterogeneity.

conclusionsMicrobial lung-to-blood translocation is a measurable biological process associated with systemic inflammatory heterogeneity in severe pneumonia. This pathway may represent a novel mechanistic target for precision therapeutic strategies aimed at mitigating immune dysregulation.

Indexed as

Host–microbe interactionMetagenomicsSevere pneumonia

Identifiers

PMID41632347
PMCPMC12868331

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.