Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity

Reena Mehta, Margaret Scheffler, Lorena Tapia, Letisha Aideyan, Kirtida D. Patel, Alan M. Jewell, Vasanthi Avadhanula, Minghua Mei, Roberto Garofalo, Pedro A. Piedra

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Bronchiolitis is the leading cause of hospitalization in infants. Biomarkers of disease severity might help in clinical management. Objective: To determine the clinical predictiveness of NW-LDH, NW-caspase 3/7, and NW-LDH/NW-caspase 3/7 ratio in bronchiolitis. Methods: Previously healthy children less than 24 months of age with bronchiolitis were recruited from the Texas Children's emergency room and intensive care unit from October 2010 to April 2011. Demographic, clinical information, and NW samples were obtained at enrollment. NW samples were analyzed for respiratory viruses, caspase 3/7, and LDH. Results: A viral pathogen was detected in 91·6% of 131 children, with the most common being respiratory syncytial virus and human rhinovirus. A single infection was found in 61·8% of subjects and co-infection in 29·8%. Children admitted to ICU had significantly higher NW-LDH than children sent home from the ER or admitted to the general floor (P = 0·02). Children infected with RSV had the highest NW-LDH concentration (P = 0·03) compared with other viral infections. NW-LDH and NW-caspase were significantly correlated (r = 0·77, P < 0·0001). The univariate models showed NW-LDH and NW-LDH/NW- caspase 3/7 ratio were directly associated with hospitalization. Mutivariate regression analyses suggested a complex interaction between the biomarkers, demographics, and disposition. Conclusions: NW-LDH, NW-caspase 3/7 and NW-LDH/NW-caspase 3/7 ratio and their interactions with demographic factors are predictive of bronchiolitis severity and can help distinguish children requiring ICU-level care from those admitted to the general floor, or discharged home from the emergency center.

Original languageEnglish (US)
Pages (from-to)617-625
Number of pages9
JournalInfluenza and other Respiratory Viruses
Volume8
Issue number6
DOIs
StatePublished - Nov 1 2014

Fingerprint

Bronchiolitis
Caspase 7
Caspases
L-Lactate Dehydrogenase
Caspase 3
Demography
Hospitalization
Biomarkers
Human respiratory syncytial virus
Rhinovirus
Emergency Medical Services
Virus Diseases
Coinfection
Intensive Care Units
Hospital Emergency Service
Emergencies
Regression Analysis
Viruses
Infection

Keywords

  • Bronchiolitis
  • Caspase
  • Disease severity
  • Lactate dehydrogenase

ASJC Scopus subject areas

  • Infectious Diseases
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Mehta, R., Scheffler, M., Tapia, L., Aideyan, L., Patel, K. D., Jewell, A. M., ... Piedra, P. A. (2014). Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity. Influenza and other Respiratory Viruses, 8(6), 617-625. https://doi.org/1111/irv.12276

Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity. / Mehta, Reena; Scheffler, Margaret; Tapia, Lorena; Aideyan, Letisha; Patel, Kirtida D.; Jewell, Alan M.; Avadhanula, Vasanthi; Mei, Minghua; Garofalo, Roberto; Piedra, Pedro A.

In: Influenza and other Respiratory Viruses, Vol. 8, No. 6, 01.11.2014, p. 617-625.

Research output: Contribution to journalArticle

Mehta, R, Scheffler, M, Tapia, L, Aideyan, L, Patel, KD, Jewell, AM, Avadhanula, V, Mei, M, Garofalo, R & Piedra, PA 2014, 'Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity', Influenza and other Respiratory Viruses, vol. 8, no. 6, pp. 617-625. https://doi.org/1111/irv.12276
Mehta, Reena ; Scheffler, Margaret ; Tapia, Lorena ; Aideyan, Letisha ; Patel, Kirtida D. ; Jewell, Alan M. ; Avadhanula, Vasanthi ; Mei, Minghua ; Garofalo, Roberto ; Piedra, Pedro A. / Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity. In: Influenza and other Respiratory Viruses. 2014 ; Vol. 8, No. 6. pp. 617-625.
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abstract = "Background: Bronchiolitis is the leading cause of hospitalization in infants. Biomarkers of disease severity might help in clinical management. Objective: To determine the clinical predictiveness of NW-LDH, NW-caspase 3/7, and NW-LDH/NW-caspase 3/7 ratio in bronchiolitis. Methods: Previously healthy children less than 24 months of age with bronchiolitis were recruited from the Texas Children's emergency room and intensive care unit from October 2010 to April 2011. Demographic, clinical information, and NW samples were obtained at enrollment. NW samples were analyzed for respiratory viruses, caspase 3/7, and LDH. Results: A viral pathogen was detected in 91·6{\%} of 131 children, with the most common being respiratory syncytial virus and human rhinovirus. A single infection was found in 61·8{\%} of subjects and co-infection in 29·8{\%}. Children admitted to ICU had significantly higher NW-LDH than children sent home from the ER or admitted to the general floor (P = 0·02). Children infected with RSV had the highest NW-LDH concentration (P = 0·03) compared with other viral infections. NW-LDH and NW-caspase were significantly correlated (r = 0·77, P < 0·0001). The univariate models showed NW-LDH and NW-LDH/NW- caspase 3/7 ratio were directly associated with hospitalization. Mutivariate regression analyses suggested a complex interaction between the biomarkers, demographics, and disposition. Conclusions: NW-LDH, NW-caspase 3/7 and NW-LDH/NW-caspase 3/7 ratio and their interactions with demographic factors are predictive of bronchiolitis severity and can help distinguish children requiring ICU-level care from those admitted to the general floor, or discharged home from the emergency center.",
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T1 - Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity

AU - Mehta, Reena

AU - Scheffler, Margaret

AU - Tapia, Lorena

AU - Aideyan, Letisha

AU - Patel, Kirtida D.

AU - Jewell, Alan M.

AU - Avadhanula, Vasanthi

AU - Mei, Minghua

AU - Garofalo, Roberto

AU - Piedra, Pedro A.

PY - 2014/11/1

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N2 - Background: Bronchiolitis is the leading cause of hospitalization in infants. Biomarkers of disease severity might help in clinical management. Objective: To determine the clinical predictiveness of NW-LDH, NW-caspase 3/7, and NW-LDH/NW-caspase 3/7 ratio in bronchiolitis. Methods: Previously healthy children less than 24 months of age with bronchiolitis were recruited from the Texas Children's emergency room and intensive care unit from October 2010 to April 2011. Demographic, clinical information, and NW samples were obtained at enrollment. NW samples were analyzed for respiratory viruses, caspase 3/7, and LDH. Results: A viral pathogen was detected in 91·6% of 131 children, with the most common being respiratory syncytial virus and human rhinovirus. A single infection was found in 61·8% of subjects and co-infection in 29·8%. Children admitted to ICU had significantly higher NW-LDH than children sent home from the ER or admitted to the general floor (P = 0·02). Children infected with RSV had the highest NW-LDH concentration (P = 0·03) compared with other viral infections. NW-LDH and NW-caspase were significantly correlated (r = 0·77, P < 0·0001). The univariate models showed NW-LDH and NW-LDH/NW- caspase 3/7 ratio were directly associated with hospitalization. Mutivariate regression analyses suggested a complex interaction between the biomarkers, demographics, and disposition. Conclusions: NW-LDH, NW-caspase 3/7 and NW-LDH/NW-caspase 3/7 ratio and their interactions with demographic factors are predictive of bronchiolitis severity and can help distinguish children requiring ICU-level care from those admitted to the general floor, or discharged home from the emergency center.

AB - Background: Bronchiolitis is the leading cause of hospitalization in infants. Biomarkers of disease severity might help in clinical management. Objective: To determine the clinical predictiveness of NW-LDH, NW-caspase 3/7, and NW-LDH/NW-caspase 3/7 ratio in bronchiolitis. Methods: Previously healthy children less than 24 months of age with bronchiolitis were recruited from the Texas Children's emergency room and intensive care unit from October 2010 to April 2011. Demographic, clinical information, and NW samples were obtained at enrollment. NW samples were analyzed for respiratory viruses, caspase 3/7, and LDH. Results: A viral pathogen was detected in 91·6% of 131 children, with the most common being respiratory syncytial virus and human rhinovirus. A single infection was found in 61·8% of subjects and co-infection in 29·8%. Children admitted to ICU had significantly higher NW-LDH than children sent home from the ER or admitted to the general floor (P = 0·02). Children infected with RSV had the highest NW-LDH concentration (P = 0·03) compared with other viral infections. NW-LDH and NW-caspase were significantly correlated (r = 0·77, P < 0·0001). The univariate models showed NW-LDH and NW-LDH/NW- caspase 3/7 ratio were directly associated with hospitalization. Mutivariate regression analyses suggested a complex interaction between the biomarkers, demographics, and disposition. Conclusions: NW-LDH, NW-caspase 3/7 and NW-LDH/NW-caspase 3/7 ratio and their interactions with demographic factors are predictive of bronchiolitis severity and can help distinguish children requiring ICU-level care from those admitted to the general floor, or discharged home from the emergency center.

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KW - Caspase

KW - Disease severity

KW - Lactate dehydrogenase

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