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

Annals of Intensive Care

Maryse A. Wiewel¹  Lonneke A. van Vught¹  Esther Witteveen²  Luuk Wieske²  Lieuwe D. Bos²  Marleen Straat²  Gerie J. Glas²  Friso M. de Beer²  Janneke Horn²  Roosmarijn T. van Hooijdonk²  Marcus J. Schultz³  Anton H. van Kaam⁴  Albert P. Bos⁵  Bart Cortjens⁵  Floor Veltkamp⁵  Sarah A. Ingelse⁵  Job B. van Woensel⁵  Laura R. Schouten⁶  Roelie M. Wösten-van Asperen⁷  Thomas Walther⁸  Franziska Kohse⁸ 

[1] 0000000084992262, grid.7177.6, Center of Experimental Molecular Medicine (CEMM), Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000 0004 1937 0490, grid.10223.32, Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand;0000000084992262, grid.7177.6, Department of Neonatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Department of Pediatric Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Department of Pediatric Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000084992262, grid.7177.6, Department of Pediatric Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands;0000000090126352, grid.7692.a, Department of Pediatric Intensive Care, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands;grid.5603.0, Institute of Medical Biochemistry and Molecular Biology, University Medicine Greifswald, Greifswald, Germany;0000000123318773, grid.7872.a, Department of Pharmacology and Therapeutics, School of Medicine and School of Pharmacy, University College Cork, Cork, Ireland;

关键词: ARDS;    Angiotensin converting enzyme;    Pathophysiology;    Aging;    Host response;    Biomarkers;   

DOI  :  10.1186/s13613-019-0529-4

来源: publisher

【 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 (< 28 days corrected postnatal age), 29 children (28 days–18 years), 26 adults (18–65 years), and 17 older adults (> 65 years of age). All patients underwent a nondirected BAL within 72 h 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.

【 授权许可】

CC BY