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Juliana A, Plötz FB, Achten N, et al. Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation. Pediatr Pulmonol. 2021;56(12):3908-3915doi: 10.1002/ppul.25663.
Juliana, A., Plötz, F. B., Achten, N., Bultman, A., Jongman, R. M., van Meurs, M., Wilschut, J. C., & Zonneveld, R. (2021). Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation. Pediatric pulmonology, 56(12), 3908-3915. https://doi.org/10.1002/ppul.25663
Juliana, Amadu, et al. "Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation." Pediatric pulmonology vol. 56,12 (2021): 3908-3915. doi: https://doi.org/10.1002/ppul.25663
Juliana A, Plötz FB, Achten N, Bultman A, Jongman RM, van Meurs M, Wilschut JC, Zonneveld R. Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation. Pediatr Pulmonol. 2021 Dec;56(12):3908-3915. doi: 10.1002/ppul.25663. Epub 2021 Sep 27. PMID: 34491635.
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Pediatr Pulmonol. 2021 Dec;56(12):3908-3915. doi: 10.1002/ppul.25663. Epub 2021 Sep 27.

Requirement of respiratory support in acute bronchiolitis in infants is linked to endothelial and neutrophil activation.

Pediatric pulmonology

Amadu Juliana, Frans B Plötz, Niek Achten, Anita Bultman, Rianne M Jongman, Matijs van Meurs, Jan C Wilschut, Rens Zonneveld

Affiliations

  1. Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname.
  2. Department of Pediatrics, Tergooi Hospitals, Hilversum, The Netherlands.
  3. Emma Children's Hospital, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  4. Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  5. Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  6. Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  7. Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 34491635 DOI: 10.1002/ppul.25663

Abstract

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.

© 2021 Wiley Periodicals LLC.

Keywords: acute bronchiolitis; endothelium; infants; neutrophils; severity

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