Age-dependent differences in pulmonary host responses in ARDS: a prospective observational cohort study

被引：82

作者：

Schouten, Laura R. ^{[1
,2
,3
,11
]}

van Kaam, Anton H. ^{[4
]}

Kohse, Franziska ^{[5
,6
,7
]}

Veltkamp, Floor ^{[1
]}

Bos, Lieuwe D. ^{[2
,3
,11
]}

de Beer, Friso M. ^{[2
,3
,11
]}

van Hooijdonk, Roosmarijn T. ^{[2
,3
,11
]}

Horn, Janneke ^{[2
,3
,11
]}

Straat, Marleen ^{[2
,3
,11
]}

Witteveen, Esther ^{[2
,3
,11
]}

Glas, Gerie J. ^{[2
,3
,11
]}

Wieske, Luuk ^{[2
,3
,11
]}

van Vught, Lonneke A. ^{[8
,11
]}

Wiewel, Maryse A. ^{[8
,11
]}

Ngelse, Sarah A., I ^{[1
]}

Cortjens, Bart ^{[1
]}

van Woensel, Job B. ^{[1
]}

Bos, Albert P. ^{[1
]}

Walther, Thomas ^{[5
,6
,7
]}

Schultz, Marcus J. ^{[2
,3
,9
,11
]}

Wosten-van Asperenl, Roelie M. ^{[1
,10
]}

Hoogendijk, Arie J. ^{[11
]}

Huson, Mischa A. ^{[11
]}

van der Poll, Tom ^{[11
]}

Scicluna, Brendon ^{[11
]}

Bonten, Marc J. ^{[12
]}

Cremer, Olaf L. ^{[12
]}

Frencken, Jos F. ^{[12
]}

van de Groep, Kirsten ^{[12
]}

Klouwenberg, Peter M. Klein ^{[12
]}

Koster-Brouwer, Maria E. ^{[12
]}

Ong, David S. ^{[12
]}

Verboom, Diana M. ^{[12
]}

机构：

[1] Univ Amsterdam, Dept Pediat Intens Care, Med Ctr, Amsterdam, Netherlands

[2] Univ Amsterdam, Dept Intens Care, Med Ctr, Amsterdam, Netherlands

[3] Univ Amsterdam, LEICA, Med Ctr, Amsterdam, Netherlands

[4] Univ Amsterdam, Dept Neonatol, Med Ctr, Amsterdam, Netherlands

[5] Univ Med Greifswald, Inst Med Biochem & Mol Biol, Greifswald, Germany

[6] Univ Coll Cork, Dept Pharmacol & Therapeut, Sch Med, Cork, Ireland

[7] Univ Coll Cork, Sch Pharm, Cork, Ireland

[8] Univ Amsterdam, CEMM, Med Ctr, Amsterdam, Netherlands

[9] Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok, Thailand

[10] Univ Med Ctr Utrecht, Dept Pediat Intens Care, Wilhelmina Childrens Hosp, Lundlaan 6, NL-3584 EA Utrecht, Netherlands

[11] Univ Amsterdam, Med Ctr, Amsterdam, Netherlands

[12] Univ Med Ctr Utrecht, Utrecht, Netherlands

来源：

ANNALS OF INTENSIVE CARE | 2019年 / 9卷

关键词：

ARDS; Angiotensin converting enzyme; Pathophysiology; Aging; Host response; Biomarkers; RESPIRATORY-DISTRESS-SYNDROME; INTENSIVE-CARE-UNIT; EXPRESSION; MORTALITY; LUNGS; LIPOPOLYSACCHARIDE; INFLAMMATION; MECHANISMS; CHILDREN; ADHESION;

D O I：

10.1186/s13613-019-0529-4

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BackgroundResults from preclinical studies suggest that age-dependent differences in host defense and the pulmonary renin-angiotensin system (RAS) are responsible for observed differences in epidemiology of acute respiratory distress syndrome (ARDS) between children and adults. The present study compares biomarkers of host defense and RAS in bronchoalveolar lavage (BAL) fluid from neonates, children, adults, and older adults with ARDS.MethodsIn this prospective observational study, we enrolled mechanical ventilated ARDS patients categorized into four age groups: 20 neonates (<28days corrected postnatal age), 29 children (28days-18years), 26 adults (18-65years), and 17 older adults (>65years of age). All patients underwent a nondirected BAL within 72h after intubation. Activities of the two main enzymes of RAS, angiotensin converting enzyme (ACE) and ACE2, and levels of biomarkers of inflammation, endothelial activation, and epithelial damage were determined in BAL fluid.ResultsLevels of myeloperoxidase, interleukin (IL)-6, IL-10, and p-selectin were higher with increasing age, whereas intercellular adhesion molecule-1 was higher in neonates. No differences in activity of ACE and ACE2 were seen between the four age groups.ConclusionsAge-dependent differences in the levels of biomarkers in lungs of ARDS patients are present. Especially, higher levels of markers involved in the neutrophil response were found with increasing age. In contrast to preclinical studies, age is not associated with changes in the pulmonary RAS.

引用

页数：9

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