TY - JOUR
T1 - Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation
AU - Juliana, Amadu
AU - Plötz, Frans B.
AU - Achten, Niek
AU - Bultman, Anita
AU - Jongman, Rianne M.
AU - van Meurs, Matijs
AU - Wilschut, Jan C.
AU - Zonneveld, Rens
N1 - Publisher Copyright: © 2021 Wiley Periodicals LLC
PY - 2021/12
Y1 - 2021/12
N2 - Background: Evidence shows that activation of pulmonary vascular endothelium and neutrophils are involved in the pathophysiology of acute bronchiolitis. We hypothesized that levels of markers of endothelial activation and leukocyte counts are associated with requirement and duration of respiratory support. Methods: Thirty-four infants with bronchiolitis and eight controls were included. Nasopharyngeal swabs and blood samples were taken at admission. Serum levels of Angiopoietin (Ang)-1, Ang-2, sP-selectin, sE-selectin, vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), and leukocyte counts were measured. For univariate analysis, bronchiolitis cases were grouped into two groups, namely those not requiring and those requiring any form of respiratory support. To control for known risk factors for poor outcome (i.e., age, prematurity, and congenital heart disease), and for days post symptom onset, linear regression analysis was performed with duration of any type of respiratory support in days. Results: Ang-2 levels, Ang-2/Ang-1 ratios, sE-selectin levels, immature neutrophil count, and neutrophil/lymphocyte ratio (NLR) were higher in acute bronchiolitis versus controls. Ang-2, and NLR levels were significantly higher, and lymphocyte counts significantly lower, in infants that required respiratory support versus those that did not. Ang-2 levels (β:.32, 95% confidence interval [CI]: 0.19–1.19) and NLR (β:.68, 95% CI: 0.17–1.19) were positive predictors for the duration of respiratory support. Conclusions: Markers of endothelial and neutrophil activation are associated with respiratory support for acute bronchiolitis. Admission Ang-2 levels and NLR may be promising markers to determine requirement of respiratory support and deserve further study.
AB - Background: Evidence shows that activation of pulmonary vascular endothelium and neutrophils are involved in the pathophysiology of acute bronchiolitis. We hypothesized that levels of markers of endothelial activation and leukocyte counts are associated with requirement and duration of respiratory support. Methods: Thirty-four infants with bronchiolitis and eight controls were included. Nasopharyngeal swabs and blood samples were taken at admission. Serum levels of Angiopoietin (Ang)-1, Ang-2, sP-selectin, sE-selectin, vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), and leukocyte counts were measured. For univariate analysis, bronchiolitis cases were grouped into two groups, namely those not requiring and those requiring any form of respiratory support. To control for known risk factors for poor outcome (i.e., age, prematurity, and congenital heart disease), and for days post symptom onset, linear regression analysis was performed with duration of any type of respiratory support in days. Results: Ang-2 levels, Ang-2/Ang-1 ratios, sE-selectin levels, immature neutrophil count, and neutrophil/lymphocyte ratio (NLR) were higher in acute bronchiolitis versus controls. Ang-2, and NLR levels were significantly higher, and lymphocyte counts significantly lower, in infants that required respiratory support versus those that did not. Ang-2 levels (β:.32, 95% confidence interval [CI]: 0.19–1.19) and NLR (β:.68, 95% CI: 0.17–1.19) were positive predictors for the duration of respiratory support. Conclusions: Markers of endothelial and neutrophil activation are associated with respiratory support for acute bronchiolitis. Admission Ang-2 levels and NLR may be promising markers to determine requirement of respiratory support and deserve further study.
KW - acute bronchiolitis
KW - endothelium
KW - infants
KW - neutrophils
KW - severity
UR - http://www.scopus.com/inward/record.url?scp=85115882451&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ppul.25663
DO - https://doi.org/10.1002/ppul.25663
M3 - Article
C2 - 34491635
SN - 8755-6863
VL - 56
SP - 3908
EP - 3915
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 12
ER -