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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.
Unlabelled:
Fibronectin (a glycoprotein which modulates inflammation) may decrease mortality in systemic infection. Children with meningococcal disease (MCD) may have low fibronectin levels. We aimed to compare plasma fibronectin levels in children with MCD and controls, correlate fibronectin levels with interleukin-6 (IL-6), shock and death, and assess fibronectin as an aid to early diagnosis in MCD. Samples were taken on admission from 99 children with MCD and 49 controls. Plasma fibronectin was measured using a turbidimetric immunoassay. Plasma fibronectin was significantly lower in MCD compared to controls (57 micrograms/ml vs 105 micrograms/ml; P < 0.005). Children who died had significantly lower levels than survivors (29 micrograms/ml vs 62 micrograms/ml; P = 0.01). Fibronectin levels were negatively correlated with IL-6 levels. Fibronectin was a poor predictor of MCD.
Conclusion:
Plasma fibronectin levels are decreased in children with MCD, especially in shock and death. This decrease is associated with high IL-6 levels. Fibronectin could be a novel therapy in severe MCD.
Insights
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.