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Published on: August 7, 2017
Urine Club Cell 16-kDa Secretory Protein and Childhood Wheezing Illnesses After Lower Respiratory Tract Infections in
Christian Rosas-Salazar1, Tebeb Gebretsadik2, Kecia N Carroll3
1Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University School of Medicine , Nashville, Tennessee. ; Vanderbilt Center for Asthma and Environmental Health Sciences Research, Vanderbilt University , Nashville, Tennessee.
Insights
Infants with lower respiratory tract infections (LRTIs) may develop childhood wheeze. Urine club cell 16-kDa secretory protein (CC16) levels during LRTIs may predict wheezing risk, offering a potential biomarker for early detection.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Biomarkers
Background:
- Infants with lower respiratory tract infections (LRTIs) face an elevated risk of developing childhood wheezing illnesses, including asthma.
- Predicting which infants are susceptible to these long-term respiratory outcomes remains a clinical challenge.
- Club cell 16-kDa secretory protein (CC16) is a potential biomarker implicated in lung health and disease.
Purpose of the Study:
- To investigate the association between urine CC16 levels during an infant LRTI and the subsequent development of childhood wheezing illnesses.
- To determine if urine CC16 can serve as a predictive biomarker for long-term respiratory outcomes following infant LRTIs.
Main Methods:
- A prospective study enrolled 133 previously healthy infants presenting with an LRTI.
- Urine CC16 levels were measured at enrollment using a validated enzyme-linked immunosorbent assay.
- Infants were followed for one year to assess the incidence of childhood wheeze, with logistic regression used for analysis.
Main Results:
- A twofold increase in urine CC16 levels was associated with approximately 30% decreased odds of developing subsequent childhood wheeze (OR = 0.74, p = 0.04).
- This inverse association remained significant after adjusting for potential confounding factors.
- Median urine CC16 levels showed a trend towards being lower in infants who later developed wheeze, though not statistically significant in the initial comparison (p=0.11).
Conclusions:
- Urine CC16 levels measured during an infant LRTI are inversely associated with the risk of developing childhood wheezing illnesses.
- Urine CC16 shows promise as a non-invasive biomarker for identifying infants at risk for persistent wheezing after LRTIs.
- Further research is warranted to validate urine CC16 as a predictive tool in clinical practice for infant respiratory health.
Abstract:
Infants with lower respiratory tract infections (LRTIs) are at an increased risk of developing childhood wheezing illnesses (including asthma), but it is not currently possible to predict those at risk for these long-term outcomes. The current objective was to examine whether urine levels of club cell 16-kDa secretory protein (CC16) at the time of an infant LRTI are associated with the development of childhood wheezing illnesses. Prospective study of 133 previously healthy infants enrolled during a healthcare visit for a LRTI and followed longitudinally for childhood wheezing illnesses. Urine levels of CC16 at the time of enrollment were measured after validating a commercially available enzyme-linked immunosorbent assay kit for serum. The outcome of interest was parental report of subsequent childhood wheeze (defined as ≥1 episode of wheezing following the initial LRTI) at the 1-year follow-up visit. Logistic regression was used for the main analysis. The median (interquartile range) urine levels of CC16 (ng/mg of creatinine) at the time of an infant LRTI were 11.1 (7.7-20.1) for infants with subsequent childhood wheeze and 13.4 (8.3-61.1) for those without (p = 0.11). In the main multivariate analysis using a logarithmic transformation of the urine levels of CC16, a twofold increase in urine levels of CC16 was associated with ∼30% decreased odds (OR = 0.74 [95% confidence interval (CI) 0.56-0.98], p = 0.04) of subsequent childhood wheeze after adjustment for potential confounders. An inverse association was found between urine levels of CC16 at the time of an infant LRTI and the odds of subsequent childhood wheeze. Urine CC16 may be a useful biomarker of the development of childhood wheezing illnesses after LRTIs in infancy.
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