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. 2014 Nov;8(6):617-25.
doi: 10.1111/irv.12276. Epub 2014 Aug 12.

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

Reena Mehta  1 , Margaret Scheffler, Lorena Tapia, Letisha Aideyan, Kirtida D Patel, Alan M Jewell, Vasanthi Avadhanula, Minghua Mei, Roberto P Garofalo, Pedro A Piedra
Affiliations

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

Reena Mehta et al. Influenza Other Respir Viruses. 2014 Nov.

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.

Keywords: Bronchiolitis; caspase; disease severity; lactate dehydrogenase.

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Figures

Figure 1
Figure 1
LDH in Nash Wash (log10 mU/l) according to the three categories of disposition: HOME + OBS, ACU, and ICU.
Figure 2
Figure 2
(A) LDH in Nasal Wash ((log10 mU/l) Compared to Different Viruses. (B) Caspase 3/7 Activity in Nasal Wash compared to Different Viruses.
Figure 3
Figure 3
Correlation of LDH to caspase 3/7 Activity in Nasal Wash.
See this image and copyright information in PMC

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