Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Pediatr Pulmonol. 2020 Sep;55(9):2457-2462. doi: 10.1002/ppul.24947. Epub 2020 Jul 15.
Serum C-reactive protein (CRP) is a sensitive biomarker for inflammation and is broadly used to clinically diagnose infectious diseases, including pneumonia. However, blood sampling is fraught with technical difficulties in children. The salivary analysis may be a potential diagnostic tool, as it is noninvasive, patient-friendly, and easy to perform in children. This study aimed to evaluate the use of salivary CRP as a biomarker for children with pneumonia.
A prospective study was conducted in patients aged 2 to 17 years, admitted to the hospital with pneumonia. Saliva and serum samples for CRP and chemokine determination were collected at the initial admission and during a follow-up from pediatric patients with pneumonia. Salivary samples were also collected from healthy subjects used as controls.
A total of 60 healthy children and 106 pediatric patients with pneumonia were enrolled in this study. The salivary CRP level was much higher in pediatric patients with pneumonia than in healthy children (48.77 ± 5.52 ng/mL vs 14.78 ± 3.92 ng/mL; P < .001). Salivary CRP level was highly correlated with serum CRP level in pediatric patients with pneumonia (r = .679; P < .001). Salivary CRP level (≥40.307 ng/mL) can be used to predict high serum CRP levels (≥80 mg/L) with an area under the curve of 0.810 (95% confidence interval, 0.740-0.881). As pneumonia improved, both salivary and serum CRP levels decreased during follow-up.
Salivary CRP could be an alternative biomarker for serum CRP in pediatric patients with pneumonia. This is especially beneficial for pediatric patients, as saliva collection is simple, noninvasive, and patient-friendly.
血清 C 反应蛋白（CRP）是炎症的敏感生物标志物，广泛用于临床诊断包括肺炎在内的传染病。然而，血液采样在儿童中存在技术困难。唾液分析可能是一种潜在的诊断工具，因为它是非侵入性的、患者友好的，并且易于在儿童中进行。本研究旨在评估唾液 CRP 作为肺炎患儿的生物标志物的用途。
对因肺炎入院的 2 至 17 岁的患者进行前瞻性研究。在肺炎患儿的初始入院和随访期间采集唾液和血清样本以测定 CRP 和趋化因子。还收集了健康受试者的唾液样本作为对照。
本研究共纳入 60 名健康儿童和 106 名肺炎患儿。肺炎患儿的唾液 CRP 水平明显高于健康儿童（48.77±5.52ng/mL vs 14.78±3.92ng/mL；P<0.001）。肺炎患儿的唾液 CRP 水平与血清 CRP 水平高度相关（r=0.679；P<0.001）。唾液 CRP 水平（≥40.307ng/mL）可用于预测血清 CRP 水平（≥80mg/L）较高，曲线下面积为 0.810（95%置信区间，0.740-0.881）。随着肺炎的改善，在随访期间，唾液和血清 CRP 水平均降低。
唾液 CRP 可作为肺炎患儿血清 CRP 的替代生物标志物。这对于儿科患者特别有益，因为唾液采集简单、非侵入性且患者友好。
