Ammar Saadoon Alishlash, Zhihong Yu, Ahmed Lazrak, Ryne Simpson, Guillermo Beltran Ale, William T Harris, Sadis Matalon
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Pediatric pulmonologists diagnosed CPA based on video-fluoroscopic swallowing evaluation.</p><p><strong>Results: </strong>Fifteen children (mean age 6.1 years, male predominance at 73%, and 53% with CPA) were enrolled. Children with CPA have comparable baseline characteristics (age, sex, and race), but their BAL had higher white blood cell count, higher neutrophil percentages, higher bacterial culture positivity rates, and lower macrophage percentages than those without CPA. The two groups were comparable in sex, BAL lymphocyte percentages, eosinophil percentages, red blood cell counts, and lipid-laden macrophage positivity. Detection of BAL LMW-HA in the BAL had a 100% specificity and 88% sensitivity for CPA diagnosis. BAL protein levels were higher in the CPA group and in participants with positive LMW-HA.</p><p><strong>Conclusions: </strong>We suggest BAL LMW-HA as a potential novel biomarker of pediatric CPA with high specificity and sensitivity. 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引用次数: 0
摘要
目的：低分子量透明质酸（LMW-HA）是肺损伤后，高分子量透明质酸在肺间质和肺泡上皮的反应性中间产物降解产生的。我们旨在研究支气管肺泡灌洗液（BAL）LMW-HA作为小儿慢性肺吸虫（CPA）生物标志物的作用：单中心前瞻性比较了接受临床指征支气管镜检查的患有和未患有 CPA 的儿科呼吸道患者 BAL 中的 LMW-HA。小儿肺科医生根据视频荧光屏吞咽评估诊断 CPA：15 名儿童（平均年龄 6.1 岁，男性占 73%，53% 患有 CPA）入组。患 CPA 的儿童具有相似的基线特征（年龄、性别和种族），但其 BAL 的白细胞计数、中性粒细胞百分比、细菌培养阳性率和巨噬细胞百分比均高于未患 CPA 的儿童。两组在性别、BAL 淋巴细胞百分比、嗜酸性粒细胞百分比、红细胞计数和脂质巨噬细胞阳性率方面具有可比性。在 BAL 中检测到 LMW-HA 对 CPA 诊断的特异性为 100%，敏感性为 88%。CPA组和LMW-HA阳性者的BAL蛋白水平较高：我们建议将 BAL LMW-HA 作为小儿 CPA 的潜在新型生物标记物，其特异性和敏感性都很高。在未患 CPA 的受试者中检测不到 BAL LMW-HA，且与 BAL 蛋白水平升高有关。
Pediatric Chronic Pulmonary Aspiration Is Associated With Low Molecular Weight Hyaluronic Acid in the Bronchoalveolar Lavage.
Objectives: Low molecular-weight hyaluronic acid (LMW-HA) is produced by the degradation of high-molecular-weight hyaluronic acid at the pulmonary interstitium and alveolar epithelium by reactive intermediates following lung injury. We aimed to investigate the role of bronchoalveolar lavage (BAL) LMW-HA as a biomarker of pediatric chronic pulmonary aspiration (CPA).
Methods: Single-center prospective comparison of LMW-HA presence in BAL in pediatric Aerodigestive patients with and without CPA undergoing clinically indicated bronchoscopy. Pediatric pulmonologists diagnosed CPA based on video-fluoroscopic swallowing evaluation.
Results: Fifteen children (mean age 6.1 years, male predominance at 73%, and 53% with CPA) were enrolled. Children with CPA have comparable baseline characteristics (age, sex, and race), but their BAL had higher white blood cell count, higher neutrophil percentages, higher bacterial culture positivity rates, and lower macrophage percentages than those without CPA. The two groups were comparable in sex, BAL lymphocyte percentages, eosinophil percentages, red blood cell counts, and lipid-laden macrophage positivity. Detection of BAL LMW-HA in the BAL had a 100% specificity and 88% sensitivity for CPA diagnosis. BAL protein levels were higher in the CPA group and in participants with positive LMW-HA.
Conclusions: We suggest BAL LMW-HA as a potential novel biomarker of pediatric CPA with high specificity and sensitivity. BAL LMW-HA is not detectable in subjects without CPA and is associated with increased BAL protein levels.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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