Azarsiz Elif, Karaca Neslihan, Kutukculer Necil
Department of Clinical Biochemistry, Ege University Faculty of Medicine, 35040 Bornova- Izmir, Turkey.
Department of Pediatric Immunology, Ege University Faculty of Medicine, Izmir, Turkey.
Indian J Clin Biochem. 2023 Oct;38(4):475-484. doi: 10.1007/s12291-022-01061-9. Epub 2022 Sep 9.
The development of lower respiratory complications in children with primary immunodeficiencies characterized by recurrent infections significantly contributes to morbidity and mortality. This is clinically more important and specific in the evaluation of prognosis. The inflammatory response that develops throughout the clinical process can cause the release of several biomarkers. This study aimed to evaluate the inflammatory biomarker "mid-regional pro-adrenomedullin (MR-proADM)" levels by distribution of lower respiratory tract complications. Plasma MR-proADM levels were measured in children with (n = 52) and without (n = 103) lower respiratory tract complications. The complicated group was also evaluated as "infective and non-infective" groups. The median MR-proADM levels were higher in the complicated cases (p = 0.175). It was 205.5 (73.4- 562.6) ng/L in the infective group while it was 96.1 (26.1-43.3) ng/L in the non-infective group and the difference between the two groups was statistically significant (p = 0.003). The predictive value of MR-proADM (AUC = 0.749, p = 0.003) was statistically significant compared to CRP (AUC = 0.330, p = 0.040) and SAA (AUC = 0.261, p = 0.004) in the infective group. This study evidences that the MR-proADM levels are higher in PID cases with infective pulmonary complications. Among other markers, MR-proADM appears to be a particularly good predictive inflammation marker for these children.
The online version contains supplementary material available at 10.1007/s12291-022-01061-9.
以反复感染为特征的原发性免疫缺陷儿童发生下呼吸道并发症，对发病率和死亡率有显著影响。这在预后评估中在临床上更为重要且具有特异性。在整个临床过程中发生的炎症反应可导致多种生物标志物的释放。本研究旨在通过下呼吸道并发症的分布情况评估炎症生物标志物“中段前肾上腺髓质素（MR-proADM）”水平。对有（n = 52）和无（n = 103）下呼吸道并发症的儿童测量血浆MR-proADM水平。复杂组也分为“感染性和非感染性”组进行评估。复杂病例的MR-proADM水平中位数较高（p = 0.175）。感染组为205.5（73.4 - 562.6）ng/L，非感染组为96.1（26.1 - 43.3）ng/L，两组间差异有统计学意义（p = 0.003）。在感染组中，与CRP（AUC = 0.330，p = 0.040）和SAA（AUC = 0.261，p = 0.004）相比，MR-proADM的预测价值（AUC = 0.749，p = 0.003）有统计学意义。本研究证明，有感染性肺部并发症的原发性免疫缺陷病例中MR-proADM水平较高。在其他标志物中，MR-proADM似乎是这些儿童特别好的预测性炎症标志物。
在线版本包含可在10.1007/s12291-022-01061-9获取的补充材料。
