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[Lactate dehydrogenase isoenzymes and alveolar inflammation in acute severe bronchiolitis in infants]
G Baldini1, A Cappuccio, A Ruschi
1Istituto di Clinica Pediatrica, Università di Pisa, Italia.
Insights
Lactate Dehydrogenase (LD) isoenzyme analysis in infants with severe acute viral bronchiolitis may indicate alveolar injury. Elevated LD4, LD3, and LD5 levels correlated with radiographic consolidation, suggesting inflammation.
Area of Science:
- Biochemistry
- Pediatric Pulmonology
- Medical Diagnostics
Context:
- Severe acute viral bronchiolitis is a common pediatric respiratory illness.
- Alveolar injury can occur secondary to inflammation or atelectasis in bronchiolitis.
- Lactate Dehydrogenase (LD) isoenzymes are intracellular enzymes released upon cell damage.
Purpose:
- To investigate the utility of Lactate Dehydrogenase (LD) isoenzyme measurement in detecting alveolar injury in infants with severe acute viral bronchiolitis.
- To correlate changes in LD isoenzyme levels with radiographic findings of alveolar consolidation.
Summary:
- Chest radiography revealed consolidation in 76.4% of infants with bronchiolitis.
- Significant increases in LD4 (70.5%), LD3 (35.2%), and LD5 (29.4%) isoenzymes were observed in affected children compared to a control group.
- Pathological findings in deceased children, including degenerated macrophages and increased lymphocytes, support an inflammatory origin for LD isoenzyme alterations.
Impact:
- This study suggests that LD isoenzyme analysis can serve as a potential biomarker for alveolar injury in pediatric viral bronchiolitis.
- Findings may aid in understanding the pathophysiology of lung damage in severe bronchiolitis.
- Further research could explore the clinical application of LD isoenzymes in managing pediatric respiratory infections.
Abstract:
The authors have tried to value in 17 children (age: 1-11 months) affected by a severe acute viral bronchiolitis, if the measurement of Lactate Dehydrogenase (LD) isoenzymes could have been used to reveal alveolar injury. In the 76.4% (13/17) of subjects areas of consolidation were demonstrated by chest's radiographic examination due either to atelectasis secondary to obstruction or to inflammation of the alveoli. These coincided with a significant increase respect to a check's group (18 children) of LD4 in 70.5% (12/17), LD3 in 35.2% (6/17) and LD5 in 29.4% (5/17) of children. The presence of an analogous electrophoretic pattern and macrophages degenerated in pulmonary alveolar proteinosis lavage effluent associated with increases in lymphocytes and mononuclear phagocytes in lung specimens from children dead for bronchiolitis help to understand the inflammatory origin of pathological modification of LD isoenzymes observed in this series of cases.