JOPIC
Journal of Pulmonology and Intensive Care

The JoPIC is an independent-unbiased, peer-reviewed, and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, surgical techniques, differential diagnoses, editorial opinions, letters to the editor, and educational papers in pulmonology, thoracic surgery, occupational diseases, allergology, and intensive care medicine.

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Original Article
The relationship between troponin levels in pneumonia and the severity of pneumonia and the oxidant-antioxidant balance
Abstract
Aims: This study aimed to determine the association between serum troponin levels and pneumonia severity, and to evaluate the oxidant-antioxidant balance in patients with community-acquired pneumonia.
Methods: A total of 100 patients diagnosed with community-acquired pneumonia and 100 healthy volunteers were enrolled in this prospective, case-control study conducted at Ankara City Hospital between October and December 2019. Troponin, native thiol, total thiol, disulphide, ischemia-modified albumin, C-reactive protein , and procalcitonin levels were analyzed and compared between groups. Pneumonia severity was determined using the Pneumonia Severity Index.
Results: Troponin levels were significantly higher in the pneumonia group than in the control group (p<0.05), with a mean troponin of 48.03 ng/L in pneumonia patients and 3.15 ng/L in controls. Troponin levels correlated positively with c-reactive protein and procalcitonin values (p<0.05) and were significantly higher in patients with abnormal echocardiography and electrocardiogram findings. Native thiol and total thiol levels were significantly lower in pneumonia patients, while the disulphide/native thiol and disulphide/total thiol ratios were higher (p<0.05). Ischemia-modified albumin, levels were also higher in the pneumonia group (p<0.05). Troponin and ischemia-modified albümin levels increased significantly with pneumonia severity index stage.
Conclusion: Elevated serum troponin and ischemia-modified albümin levels, along with altered thiol-disulphide balance, may reflect increased oxidative stress and disease severity in pneumonia. These biomarkers may contribute to clinical assessment and prognosis in pneumonia cases.

Keywords : Pneumonia, cardiac troponin, thiol, disulfide, ischemia-modified albumin

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1. Ozlu T, Bulbul Y, Alatas F, et al. Consensus report on diagnosis and treatment of community-acquired pneumonia in adults. Tuberk Toraks. 2009;57(2):119-147.
2. Welte T, Suttorp N, Marre R. CAPNETZ-community-acquired pneumonia competence network. Infection. 2004;32(4):234-238. doi:10. 1007/s15010-004-3107-z
3. Almirall J, Bolíbar I, Vidal J, et al. Epidemiology of community-acquired pneumonia in adults: a population-based study. Eur Respir J. 2000;15(4):757-763. doi:10.1034/j.1399-3003.2000.15d21.x
4. Cemek M, Caksen H, Bayiroğlu F, Cemek F, Dede S. Oxidative stress and enzymic-non-enzymic antioxidant responses in children with acute pneumonia. Cell Biochem Funct. 2006;24(3):269-273. doi:10.1002/cbf.1220
5. Celebi OO, Diker E, Aydogdu S. Clinical importance of cardiac troponins. Turk Kardiyol Dern Ars. 2008;36(4):269-277.
6. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47(18):326-332. doi:10.1016/j.clinbiochem. 2014.09.026
7. Parlak ES, Alisik M, Karalezli A, et al. Are the thiol/disulfide redox status and HDL cholesterol levels associated with pulmonary embolism?: thiol/disulfide redox status in pulmonary embolism. Clin Biochem. 2017;50(18):1020-1024. doi:10.1016/j.clinbiochem.2017.07.018
8. Parlak ES, Alisik M, Hezer H, Karalezli A, Hasanoglu HC, Erel O. Evaluation of dynamic thiol/disulfide redox state in community-acquired pneumonia. Saudi Med J. 2018;39(5):495-499. doi:10.15537/smj.2018.5.22111
9. Babaoglu E, Kilic H, Hezer H, et al. Comparison of thiol/disulphide homeostasis parameters in patients with COPD, asthma and ACOS. Eur Rev Med Pharmacol Sci. 2016;20(8):1537-1543.
10. Wudkowska A, Goch J, Goch A. Ischemia-modified albumin in differential diagnosis of acute coronary syndrome without ST elevation and unstable angina pectoris. Kardiol Pol. 2010;68(4):431-437.
11. Aran T, Unsal MA, Guven S, Kart C, Cetin EC, Alver A. Carbon dioxide pneumoperitoneum induces systemic oxidative stress: a clinical study. Eur J Obstet Gynecol Reprod Biol. 2012;161(1):80-83. doi:10.1016/j.ejogrb.2011.11.027
12. Ma SG, Wei CL, Hong B, Yu WN. Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease. Clinics (Sao Paulo). 2011;66(10):1677-1680. doi:10.1590/s1807-59322011001000003
13. Lippi G, Montagnana M. Ischemia-modified albumin in ischemic disorders. Ann Thorac Cardiovasc Surg. 2009;15(2):137.
14. Vasile VC, Chai HS, Abdeldayem D, Afessa B, Jaffe AS. Elevated cardiac troponin T levels in critically ill patients with sepsis. Am J Med. 2013; 126(12):1114-1121. doi:10.1016/j.amjmed.2013.06.029
15. Jaffe AS, Ravkilde J, Roberts R, et al. It’s time for a change to a troponin standard. Circulation. 2000;102(11):1216-1220. doi:10.1161/01.cir.102. 11.1216
16. Pollack ML. ECG manifestations of selected extracardiac diseases. Emerg Med Clin North Am. 2006;24(1):133-143. doi:10.1016/j.emc.2005. 08.009
17. Rubio-Tapia A, García-Leiva J, Asensio-Lafuente E, Robles-Díaz G, Vargas-Vorácková F. Electrocardiographic abnormalities in patients with acute pancreatitis. J Clin Gastroenterol. 2005;39(9):815-818. doi:10. 1097/01.mcg.0000177241.74838.57
18. Frencken JF, Donker DW, Spitoni C, et al. Myocardial injury in patients with sepsis and its association with long-term outcome. Circ Cardiovasc Qual Outcomes. 2018;11(2):e004040. doi:10.1161/CIRCOUTCOMES. 117.004040
19. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-2264. doi:10.1016/j.jacc.2018.08.1038
20. Upadhyay S, Niederman MS. Biomarkers: what is their benefit in the identification of infection, severity assessment, and management of community-acquired pneumonia? Infect Dis Clin North Am. 2013;27(1): 19-31. doi:10.1016/j.idc.2012.11.003
21. Schuetz P, Suter-Widmer I, Chaudri A, et al. Prognostic value of procalcitonin in community-acquired pneumonia. Eur Respir J. 2011; 37(2):384-392. doi:10.1183/09031936.00035610
22. Kundi H, Ates I, Kiziltunc E, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis. Am J Emerg Med. 2015;33(11):1567-1571. doi:10.1016/j.ajem.2015.06.016
23. Şener A, Kurtoğlu Çelik G, Özhasenekler A, et al. Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia. Hong Kong J Emerg Med. 2019;26(6):343-350. doi: 10.1177/1024907918802956
24. Temel MT, Demiryürek S, Temel L, et al. Dynamic thiol/disulfide homeostasis in children with community-acquired pneumonia. Pediatr Int. 2019;61(3):252-257. doi:10.1111/ped.13773
25. Bolatkale M, Duger M, Ülfer G, et al. A novel biochemical marker for community-acquired pneumonia: Ischemia-modified albumin. Am J Emerg Med. 2017;35(8):1121-1125. doi:10.1016/j.ajem.2017.03.018
1. Ozlu T, Bulbul Y, Alatas F, et al. Consensus report on diagnosis and treatment of community-acquired pneumonia in adults. Tuberk Toraks. 2009;57(2):119-147.
2. Welte T, Suttorp N, Marre R. CAPNETZ-community-acquired pneumonia competence network. Infection. 2004;32(4):234-238. doi:10. 1007/s15010-004-3107-z
3. Almirall J, Bolíbar I, Vidal J, et al. Epidemiology of community-acquired pneumonia in adults: a population-based study. Eur Respir J. 2000;15(4):757-763. doi:10.1034/j.1399-3003.2000.15d21.x
4. Cemek M, Caksen H, Bayiroğlu F, Cemek F, Dede S. Oxidative stress and enzymic-non-enzymic antioxidant responses in children with acute pneumonia. Cell Biochem Funct. 2006;24(3):269-273. doi:10.1002/cbf.1220
5. Celebi OO, Diker E, Aydogdu S. Clinical importance of cardiac troponins. Turk Kardiyol Dern Ars. 2008;36(4):269-277.
6. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47(18):326-332. doi:10.1016/j.clinbiochem. 2014.09.026
7. Parlak ES, Alisik M, Karalezli A, et al. Are the thiol/disulfide redox status and HDL cholesterol levels associated with pulmonary embolism?: thiol/disulfide redox status in pulmonary embolism. Clin Biochem. 2017;50(18):1020-1024. doi:10.1016/j.clinbiochem.2017.07.018
8. Parlak ES, Alisik M, Hezer H, Karalezli A, Hasanoglu HC, Erel O. Evaluation of dynamic thiol/disulfide redox state in community-acquired pneumonia. Saudi Med J. 2018;39(5):495-499. doi:10.15537/smj.2018.5.22111
9. Babaoglu E, Kilic H, Hezer H, et al. Comparison of thiol/disulphide homeostasis parameters in patients with COPD, asthma and ACOS. Eur Rev Med Pharmacol Sci. 2016;20(8):1537-1543.
10. Wudkowska A, Goch J, Goch A. Ischemia-modified albumin in differential diagnosis of acute coronary syndrome without ST elevation and unstable angina pectoris. Kardiol Pol. 2010;68(4):431-437.
11. Aran T, Unsal MA, Guven S, Kart C, Cetin EC, Alver A. Carbon dioxide pneumoperitoneum induces systemic oxidative stress: a clinical study. Eur J Obstet Gynecol Reprod Biol. 2012;161(1):80-83. doi:10.1016/j.ejogrb.2011.11.027
12. Ma SG, Wei CL, Hong B, Yu WN. Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease. Clinics (Sao Paulo). 2011;66(10):1677-1680. doi:10.1590/s1807-59322011001000003
13. Lippi G, Montagnana M. Ischemia-modified albumin in ischemic disorders. Ann Thorac Cardiovasc Surg. 2009;15(2):137.
14. Vasile VC, Chai HS, Abdeldayem D, Afessa B, Jaffe AS. Elevated cardiac troponin T levels in critically ill patients with sepsis. Am J Med. 2013; 126(12):1114-1121. doi:10.1016/j.amjmed.2013.06.029
15. Jaffe AS, Ravkilde J, Roberts R, et al. It’s time for a change to a troponin standard. Circulation. 2000;102(11):1216-1220. doi:10.1161/01.cir.102. 11.1216
16. Pollack ML. ECG manifestations of selected extracardiac diseases. Emerg Med Clin North Am. 2006;24(1):133-143. doi:10.1016/j.emc.2005. 08.009
17. Rubio-Tapia A, García-Leiva J, Asensio-Lafuente E, Robles-Díaz G, Vargas-Vorácková F. Electrocardiographic abnormalities in patients with acute pancreatitis. J Clin Gastroenterol. 2005;39(9):815-818. doi:10. 1097/01.mcg.0000177241.74838.57
18. Frencken JF, Donker DW, Spitoni C, et al. Myocardial injury in patients with sepsis and its association with long-term outcome. Circ Cardiovasc Qual Outcomes. 2018;11(2):e004040. doi:10.1161/CIRCOUTCOMES. 117.004040
19. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-2264. doi:10.1016/j.jacc.2018.08.1038
20. Upadhyay S, Niederman MS. Biomarkers: what is their benefit in the identification of infection, severity assessment, and management of community-acquired pneumonia? Infect Dis Clin North Am. 2013;27(1): 19-31. doi:10.1016/j.idc.2012.11.003
21. Schuetz P, Suter-Widmer I, Chaudri A, et al. Prognostic value of procalcitonin in community-acquired pneumonia. Eur Respir J. 2011; 37(2):384-392. doi:10.1183/09031936.00035610
22. Kundi H, Ates I, Kiziltunc E, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis. Am J Emerg Med. 2015;33(11):1567-1571. doi:10.1016/j.ajem.2015.06.016
23. Şener A, Kurtoğlu Çelik G, Özhasenekler A, et al. Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia. Hong Kong J Emerg Med. 2019;26(6):343-350. doi: 10.1177/1024907918802956
24. Temel MT, Demiryürek S, Temel L, et al. Dynamic thiol/disulfide homeostasis in children with community-acquired pneumonia. Pediatr Int. 2019;61(3):252-257. doi:10.1111/ped.13773
25. Bolatkale M, Duger M, Ülfer G, et al. A novel biochemical marker for community-acquired pneumonia: Ischemia-modified albumin. Am J Emerg Med. 2017;35(8):1121-1125. doi:10.1016/j.ajem.2017.03.018
Article available in :
Volume 4, Issue 1, 2026
Page : 7-13
https://doi.org/10.51271/JOPIC-0072
Article Information
Received : 18 Kas 2025
Accepted : 21 Oca 2026
Published : 12 Şub 2026
Corresponding Author :

Sevil Öner: Department of Pulmonary Diseases, Yenimahalle Training and Research Hospital, Ankara, Turkiye

[email protected]
Citation : Öner S, Karalezli A. The relationship between troponin levels in pneumonia and the severity of pneumonia and the oxidant-antioxidant balance. J Pulmonol Intens Care. 2026;4(1):7-13.

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