Evaluation of BCL2 and TNFα as mRNA biomarkers for monitoring the immune response in critically ill children
| Autor: | Ahmed Nabih El Shazly, Fatma Elzahraa Mohammed Awais, Rasha Mohammed Zakaria, Doaa R. Soliman, Shuzan A. Mohammed |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
BCL2 qRT-PCR quantitative real time PCR TNFα Tumor necrosis factor alpha MODS ROC Receiver operating characteristics 03 medical and health sciences CARS Compensatory anti-inflammatory syndrome 0302 clinical medicine PELOD Pediatric logistic organ dysfunction Internal medicine Hospital-acquired infection medicine Risk of mortality TNFα Cause of death Original Research Pediatric intensive care unit medicine.diagnostic_test business.industry Mortality rate Organ dysfunction Prediction of HAI Complete blood count 030208 emergency & critical care medicine General Medicine PICU pediatric intensive care unit BCL2 B-cell lymphoma 2 medicine.disease HAI Hospital acquired infection CDC Centers for disease control AUC Area under the curve Quantitative real time PCR 030220 oncology & carcinogenesis OFI Organ failure index cDNA Complementary DNA Surgery medicine.symptom Complication business MODS Multiple organ dysfunctions Critical illness |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Background Hospital acquired infection (HAI) and multiple organ dysfunctions (MODS) remain a leading cause of death in pediatric intensive care unit (PICU) despite the great efforts to control it. Objective Our objective was to assess the mRNA of TNFα and BCL2 for prediction of HAI and/or MODS in our community. Patients and methods Fifty children, admitted to PICU, were included in the study after exclusion of cases of end-stage renal failure, end-stage liver failure and congenital immune deficiency. Serial Blood samples were collected for complete blood count (CBC) and other routine investigations. Gene expression of (TNFα and BCL2) was quantified using quantitative real time PCR (qRT-PCR). Centers of disease control (CDC) criteria were used to detect HAI, and organ failure index (OFI). Pediatric logistic organ dysfunction (PELOD) and pediatric risk of mortality (PRISM) scores were used for follow up. The results were compared between the group who acquired HAI and who didn't. Gene expression was tested with a ROC curve to detect its ability to predict HAI. Main results The overall complication (HAI and/or MODS) rate was 52%, Complicated cases had a significantly longer duration of stay in PICU (0.002) and in overall hospital stay (p = 0.013) and a higher death rate (p = 0.000). On day1; TNFα, BCL2 and lymphocytic count were lower in patients who developed complications (p = 0.02, p = 0.000 and p = 0.04, respectively), all had the ability to predict the complications with AUC (0.7, 0.8 and 0.67 respectively). On day 4: TNFα and BCL2 returned to normal levels while the lymphocytic count still lower in complicated cases, p = 0.001 and AUC = 0.73. Conclusions TNFα and BCL2 on admission can predict HAI and MODS (AUC = 0.7 and AUC = 0.8), but were of no use in the follow-up, however, the lymphocytic count is a rapid, easy and cheap test to assess the immune state with a good predictive and follow up values. Highlights • To our knowledge, our work is the 1st to show mRNA biomarkers in acquired immunosuppressed critically ill Egyptian children. • The current study provides a new evidence that immune suppression can be measured and opens the way for further studies. • We mainly found that TNFα and BCL2 can predict HAI and MODS on admission but they were of no use in the follow-up. • Lymphocytic count, a rapid, easy and cheap test, can assess the immune state with a good predictive and follow up values. |
| Databáze: | OpenAIRE |
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