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Mid-Regional Proadrenomedullin Levels in Primary Immunodeficiencies Complicated with Pulmonary Manifestations

Elif Azarsiz1, Neslihan Karaca2, Necil Kutukculer2

  • 1Department of Clinical Biochemistry, Ege University Faculty of Medicine, 35040 Bornova- Izmir, Turkey.

Indian Journal of Clinical Biochemistry : IJCB
|September 25, 2023
PubMed

Insights

Children with primary immunodeficiencies (PID) and lower respiratory complications show higher mid-regional pro-adrenomedullin (MR-proADM) levels. MR-proADM is a promising predictive biomarker for infective pulmonary complications in these children.

Area of Science:

  • Pediatric Immunology
  • Pulmonology
  • Biomarker Research

Background:

  • Lower respiratory complications significantly increase morbidity and mortality in children with primary immunodeficiencies (PID).
  • Inflammatory responses in these children can release various biomarkers, crucial for prognosis evaluation.
  • Identifying specific biomarkers is essential for managing and predicting outcomes in PID patients.

Purpose of the Study:

  • To evaluate mid-regional pro-adrenomedullin (MR-proADM) levels in relation to lower respiratory tract complications in children with PID.
  • To compare the predictive value of MR-proADM against other inflammatory markers like CRP and SAA.
  • To determine if MR-proADM can serve as a prognostic indicator for infective pulmonary complications in PID.

Main Methods:

  • Plasma MR-proADM levels were measured in children with (n=52) and without (n=103) lower respiratory tract complications.
  • The complicated group was further categorized into infective and non-infective subgroups.
  • Statistical analysis, including median level comparisons and receiver operating characteristic (ROC) curve analysis, was performed.

Main Results:

  • Median MR-proADM levels were higher in children with lower respiratory tract complications compared to those without.
  • MR-proADM levels were significantly higher in the infective subgroup (205.5 ng/L) compared to the non-infective subgroup (96.1 ng/L).
  • MR-proADM demonstrated a significant predictive value (AUC=0.749) for infective pulmonary complications, outperforming CRP and SAA.

Conclusions:

  • MR-proADM levels are elevated in children with primary immunodeficiencies experiencing infective pulmonary complications.
  • MR-proADM shows potential as a valuable predictive inflammatory biomarker for these specific complications.
  • This finding suggests MR-proADM could aid in the clinical evaluation and prognosis of children with PID and respiratory issues.

Keywords:
AdrenomedullinBiomarkersChildrenInflammationRespiratory tract infections

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