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Elastase and granzymes during meningococcal disease in children: correlation to disease severity

Job B M van Woensel1, Maarten H Biezeveld, C Erik Hack

  • 1Paediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, P.O. Box 22660, 1100DD Amsterdam, The Netherlands. j.b.vanwoensel@amc.uva.nl

Intensive Care Medicine
|July 13, 2005
PubMed

Insights

Human neutrophil elastase and granzyme B levels correlate with meningococcal disease severity in children. Prolonged neutrophil activation indicates greater organ dysfunction, impacting patient outcomes.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Immunology

Background:

  • Meningococcal disease is a severe infection in children.
  • Understanding the inflammatory response is crucial for predicting outcomes.

Purpose of the Study:

  • To investigate human neutrophil elastase (HNE) and granzymes A/B in pediatric meningococcal disease.
  • To correlate enzyme levels with disease severity and organ dysfunction.

Main Methods:

  • Clinical observational cohort study in a pediatric intensive care unit.
  • Measured HNE and granzymes A/B using ELISA on admission, day 3, and day 7.
  • Included 61 children with distinct meningitis, meningitis and shock, or fulminant septicemia.

Main Results:

  • Elevated HNE on admission, highest in fulminant septicemia.
  • Granzyme B (and marginally Granzyme A) increased in patients with shock.
  • Slower decrease in HNE levels correlated with increased need for respiratory and circulatory support.

Conclusions:

  • HNE and granzyme B are linked to initial meningococcal disease severity.
  • Sustained neutrophil activation is associated with more extensive organ dysfunction.
Abstract

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