TY - JOUR
T1 - Age-dependent differences in pulmonary host responses in ARDS: a prospective observational cohort study
AU - Schouten, Laura R.
AU - van Kaam, Anton H.
AU - Kohse, Franziska
AU - Veltkamp, Floor
AU - Bos, Lieuwe D.
AU - de Beer, Friso M.
AU - van Hooijdonk, Roosmarijn T.
AU - Horn, Janneke
AU - Straat, Marleen
AU - Witteveen, Esther
AU - Glas, Gerie J.
AU - Wieske, Luuk
AU - van Vught, Lonneke A.
AU - Wiewel, Maryse A.
AU - Ingelse, Sarah A.
AU - Cortjens, Bart
AU - van Woensel, Job B.
AU - Bos, Albert P.
AU - Walther, Thomas
AU - Schultz, Marcus J.
AU - Wösten-van Asperen, Roelie M.
AU - MARS consortium
AU - de Beer, Friso M.
AU - Bos, Lieuwe D.
AU - Glas, Gerie J.
AU - Horn, Janneke
AU - Hoogendijk, Arie J.
AU - van Hooijdonk, Roosmarijn T.
AU - Huson, Mischa A.
AU - van der Poll, Tom
AU - Scicluna, Brendon
AU - Schouten, Laura R.
AU - Schultz, Marcus J.
AU - Straat, Marleen
AU - van Vught, Lonneke A.
AU - Wieske, Luuk
AU - Wiewel, Maryse A.
AU - Witteveen, Esther
AU - Bonten, Marc J.
AU - Cremer, Olaf L.
AU - Frencken, Jos F.
AU - van de Groep, Kirsten
AU - Klein Klouwenberg, Peter M.
AU - Koster-Brouwer, Maria E.
AU - Ong, David S.
AU - Verboom, Diana M.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background: Results from preclinical studies suggest that age-dependent differences in host defense and the pulmonary renin–angiotensin system (RAS) are responsible for observed differences in epidemiology of acute respiratory distress syndrome (ARDS) between children and adults. The present study compares biomarkers of host defense and RAS in bronchoalveolar lavage (BAL) fluid from neonates, children, adults, and older adults with ARDS. Methods: In this prospective observational study, we enrolled mechanical ventilated ARDS patients categorized into four age groups: 20 neonates (< 28 days corrected postnatal age), 29 children (28 days–18 years), 26 adults (18–65 years), and 17 older adults (> 65 years of age). All patients underwent a nondirected BAL within 72 h after intubation. Activities of the two main enzymes of RAS, angiotensin converting enzyme (ACE) and ACE2, and levels of biomarkers of inflammation, endothelial activation, and epithelial damage were determined in BAL fluid. Results: Levels of myeloperoxidase, interleukin (IL)-6, IL-10, and p-selectin were higher with increasing age, whereas intercellular adhesion molecule-1 was higher in neonates. No differences in activity of ACE and ACE2 were seen between the four age groups. Conclusions: Age-dependent differences in the levels of biomarkers in lungs of ARDS patients are present. Especially, higher levels of markers involved in the neutrophil response were found with increasing age. In contrast to preclinical studies, age is not associated with changes in the pulmonary RAS.
AB - Background: Results from preclinical studies suggest that age-dependent differences in host defense and the pulmonary renin–angiotensin system (RAS) are responsible for observed differences in epidemiology of acute respiratory distress syndrome (ARDS) between children and adults. The present study compares biomarkers of host defense and RAS in bronchoalveolar lavage (BAL) fluid from neonates, children, adults, and older adults with ARDS. Methods: In this prospective observational study, we enrolled mechanical ventilated ARDS patients categorized into four age groups: 20 neonates (< 28 days corrected postnatal age), 29 children (28 days–18 years), 26 adults (18–65 years), and 17 older adults (> 65 years of age). All patients underwent a nondirected BAL within 72 h after intubation. Activities of the two main enzymes of RAS, angiotensin converting enzyme (ACE) and ACE2, and levels of biomarkers of inflammation, endothelial activation, and epithelial damage were determined in BAL fluid. Results: Levels of myeloperoxidase, interleukin (IL)-6, IL-10, and p-selectin were higher with increasing age, whereas intercellular adhesion molecule-1 was higher in neonates. No differences in activity of ACE and ACE2 were seen between the four age groups. Conclusions: Age-dependent differences in the levels of biomarkers in lungs of ARDS patients are present. Especially, higher levels of markers involved in the neutrophil response were found with increasing age. In contrast to preclinical studies, age is not associated with changes in the pulmonary RAS.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85065813716&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31089908
U2 - https://doi.org/10.1186/s13613-019-0529-4
DO - https://doi.org/10.1186/s13613-019-0529-4
M3 - Article
C2 - 31089908
SN - 2110-5820
VL - 9
SP - 55
JO - Annals of intensive care
JF - Annals of intensive care
IS - 1
M1 - 55
ER -