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Plasma fibronectin levels in meningococcal disease
F A Riordan1, K Bestwick, A P Thomson
1Department of Biochemistry, Royal Liverpool Children's Hospital, UK.
European Journal of Pediatrics
|June 1, 1997
Summary
Children with meningococcal disease (MCD) have lower fibronectin levels, particularly those experiencing shock or death. Lower fibronectin correlates with higher interleukin-6 (IL-6) but is not a reliable early diagnostic marker for MCD.
Area of Science:
- Biochemistry
- Immunology
- Pediatrics
Background:
- Fibronectin, a glycoprotein, plays a role in modulating inflammation and may reduce mortality in systemic infections.
- Previous observations suggest that children with meningococcal disease (MCD) might exhibit reduced fibronectin levels.
Purpose of the Study:
- To compare plasma fibronectin levels in children diagnosed with MCD versus healthy controls.
- To investigate the correlation between fibronectin levels, interleukin-6 (IL-6), and clinical outcomes including shock and mortality in pediatric MCD.
- To evaluate the potential of fibronectin as an early diagnostic aid for MCD.
Main Methods:
- Plasma samples were collected from 99 children with MCD and 49 controls upon admission.
- Plasma fibronectin concentrations were quantified using a turbidimetric immunoassay.
- Statistical analyses were performed to compare groups and assess correlations.
Main Results:
- Children with MCD presented significantly lower plasma fibronectin levels (57 µg/ml) compared to controls (105 µg/ml; P < 0.005).
- Survivors of MCD had higher fibronectin levels (62 µg/ml) than those who died (29 µg/ml; P = 0.01).
- Fibronectin levels showed a negative correlation with IL-6 levels, and fibronectin proved to be a poor predictor for diagnosing MCD.
Conclusions:
- Plasma fibronectin levels are notably decreased in pediatric meningococcal disease, with the lowest levels observed in cases of shock and mortality.
- The reduction in fibronectin is associated with elevated IL-6 levels, indicating a complex inflammatory response.
- Fibronectin presents potential as a novel therapeutic agent for managing severe MCD.