Detectable A Disintegrin and Metalloproteinase With Thrombospondin Motifs-1 in Serum Is Associated With Adverse Outcome in Pediatric Sepsis.

Autor:	Boeddha NP; Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.; Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands., Driessen GJ; Department of Paediatrics, Maastricht University Medical Center, Maastricht, The Netherlands., Hagedoorn NN; Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands., Kohlfuerst DS; Department of General Paediatrics, Medical University of Graz, Graz, Austria., Hoggart CJ; Section of Pediatrics, Imperial College London, London, United Kingdom.; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY., van Rijswijk AL; Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Ekinci E; Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands., Priem D; Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Schlapbach LJ; Child Health Research Center, The University of Queensland, Brisbane, QLD, Australia.; Queensland Children`s Hospital, Brisbane, QLD, Australia.; Pediatric and Neonatal Intensive Care Unit, University Children's Hospital Zurich, Zurich, Switzerland., Herberg JA; Section of Pediatrics, Imperial College London, London, United Kingdom., de Groot R; Radboudumc Technology Center Clinical Studies, Radboudumc, Nijmegen, The Netherlands.; Section of Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, The Netherlands.; Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands., Anderson ST; MRC Unit The Gambia at the LSHTM, Banjul, The Gambia., Fink CG; Micropathology Ltd, University of Warwick Science Park, Venture Centre, Coventry, United Kingdom., Carrol ED; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom., van der Flier M; Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands.; Paediatric Infectious Diseases and Immunology, Radboudumc, Nijmegen, The Netherlands., Martinón-Torres F; Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.; Genetics-Vaccines-Infectious Diseases and Pediatrics research group GENVIP, Health Research Institute of Santiago IDIS/SERGAS, Santiago de Compostela, Spain., Levin M; Section of Pediatrics, Imperial College London, London, United Kingdom., Leebeek FW; Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Zenz W; Department of General Paediatrics, Medical University of Graz, Graz, Austria., de Maat MPM; Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Hazelzet JA; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Emonts M; Paediatric Infectious Diseases and Immunology Department, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.; NIHR Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, United Kingdom., Dik WA; Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2021 Nov 08; Vol. 3 (11), pp. e0569. Date of Electronic Publication: 2021 Nov 08 (Print Publication: 2021).
DOI:	10.1097/CCE.0000000000000569
Abstrakt:	Importance: A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 is hypothesized to play a role in the pathogenesis of invasive infection, but studies in sepsis are lacking. Objectives: To study A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 protein level in pediatric sepsis and to study the association with outcome. Design: Data from two prospective cohort studies. Setting and Participants: Cohort 1 is from a single-center study involving children admitted to PICU with meningococcal sepsis (samples obtained at three time points). Cohort 2 includes patients from a multicenter study involving children admitted to the hospital with invasive bacterial infections of differing etiologies (samples obtained within 48 hr after hospital admission). Main Outcomes and Measures: Primary outcome measure was mortality. Secondary outcome measures were PICU-free days at day 28 and hospital length of stay. Results: In cohort 1 ( n = 59), nonsurvivors more frequently had A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels above the detection limit than survivors at admission to PICU (8/11 [73%] and 6/23 [26%], respectively; p = 0.02) and at t = 24 hours (2/3 [67%] and 3/37 [8%], respectively; p = 0.04). In cohort 2 ( n = 240), A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels in patients within 48 hours after hospital admission were more frequently above the detection limit than in healthy controls (110/240 [46%] and 14/64 [22%], respectively; p = 0.001). Nonsurvivors more often had detectable A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels than survivors (16/21 [76%] and 94/219 [43%], respectively; p = 0.003), which was mostly attributable to patients with Neisseria meningitidis . Conclusions and Relevance: In children with bacterial infection, detection of A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 within 48 hours after hospital admission is associated with death, particularly in meningococcal sepsis. Future studies should confirm the prognostic value of A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 and should study pathophysiologic mechanisms. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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