دراسة مستقبلات التحفيز القابلة للذوبان المعبر عنها في الخلايا النخاعية 1، بروتين شبيه الكيتيناز 3 ومستقبل منشط البلازمينوجين اليوروكيناز القابل للذوبان في الالتهاب الرئوي البكتيري عند الأطفال.

Study of Soluble Triggering Receptor Expressed on Myeloid Cells 1 ,Chitinase 3-Like Protein 1 and Soluble Urokinase Plasminogen Activator Receptor in Pediatric Bacterial Pneumonia

Abstract

Respiratory tract infections are any upper or lower respiratory disease that affect children all over the world and are associated with significant morbidity and mortality. RTIs are usually triggered by viruses, though bacterial infections are also common. Upper respiratory tract infections (URI) can be classified as acute nasopharyngitis, sinusitis, pharyngitis, tonsillitis, laryngitis, and laryngotracheitis or laryngotracheobronchitis, while lower respiratory tract infections (LRIs) include bronchitis, bronchiolitis and pneumonia.
The study was a cross-sectional and was conducted at the Babil Teaching Hospital for Maternity and Children and AL nour hospital for children in Babylon governorate, from the beginning of November 2023 to April 2024, blood and sputum samples were obtained from 120 suspected respiratory tract infections patients and divided into three groups: mild, moderate and severe after diagnostic by pediatrics, their age ranged from less than 1 years to 14 years. This study aimed to investigate the most common types of bacterial isolates responsible about upper and lower bacterial infections in children and investigate the role of biomarkers in prognostic respiratory tract infections in children.
Sputum samples were cultivated on culture media and manual biochemical tests were used to identification of bacteria species. C-reactive protein was measured by a DIRUI CS-T180 automatic chemistry analyzer and white blood Cells using a Sysmex XP-300 . The biomarkers Chitinase 3-like protein 1, sTREM-1(soluble triggering receptor expressed on myeloid cell 1) and suPAR (soluble urokinase plasminogen activator receptor) were measured by using ELISA system.
The results showed that out of 127 sputum samples, 7 had no bacterial growth ,and 120 were found with significant bacterial growth only them were include in the present work.
The results of bacterial isolates were H. influenza 21% ,Klebsiella pneumonia 20% Strep. Pneumonia 19%, Staph. aureu 15%, Staph. Pyogen 14% Pseudomonas aeruginosa 5%, and Moraxella catarrhalis 5%.
The comparison study revealed that there was increase in concentrations of all biomarkers in the severe cases of disease. The mean sTREM-1 concentrations 2841.981 ± 2816.161 ng/mL in severe cases, mean CHI3L1 concentration 2025.397±1016.498 ng/mL and suPAR concentrations 21.123±10.812 ng/mL .
Statically a significant difference was found in some parameters among the severe infections. As a result, there is a significant negative correlation between Human sTREM-1 and Human CH13L1, at the p-value< 0.05. Furthermore , there is a significant positive correlation between WBC and ESR (p-value= 0.389). There is a negative correlation among WBC with Human sTREM-1, Human CH13L1, and Human suPAR p-value< 0.05.
In moderate case was a significant positive correlation between Human sTREM-1 and Human suPAR, at the p-value< 0.05. on the other hand, there is a significant positive correlation among CRP with Human suPAR and WBC, at the p-value< 0.01. There is a negative correlation among Human sTREM-1 with Human CH13L1, and Human suPAR p-value< 0.05. consequently, there is a positive correlation among WBC with Human sTREM-1, Human CH13L1, and Human suPAR, at the p-value< 0.05, while there is a negative correlation among ESR with Human sTREM-1, Human CH13L1, and Human suPAR, at the p-value< 0.05.In addition there is strong positive correlation between WBC and CRP (0.436**) .
In mild case there is a significant positive correlation among Human CH13L1 with Human sTREM-1 and Human suPAR, at the p-value< 0.05. In addition , there is a significant positive correlation between Human sTREM-1 and Human suPAR, at the p-value< (0.05).
This study concluded that the elevated level of CRP, WBC and ESR in children with less than 1 year is much more than other age group, and serum level of Human sTREM-1, Human CH13L1, and Human suPAR were much greater in severe cases in comparison with moderate and mild cases.