Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity
Article first published online: 12 AUG 2014
© 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Influenza and Other Respiratory Viruses
Volume 8, Issue 6, pages 617–625, November 2014
How to Cite
2014) Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity. Influenza and Other Respiratory Viruses 8(6), 617–625.et al. (
- Issue published online: 28 NOV 2014
- Article first published online: 12 AUG 2014
- Manuscript Accepted: 23 JUL 2014
- Department of Defense. Grant Number: W81XWH1010146
- NIEHS. Grant Number: T32-07254
- disease severity;
- lactate dehydrogenase
Bronchiolitis is the leading cause of hospitalization in infants. Biomarkers of disease severity might help in clinical management.
To determine the clinical predictiveness of NW-LDH, NW-caspase 3/7, and NW-LDH/NW-caspase 3/7 ratio in bronchiolitis.
Previously healthy children less than 24 months of age with bronchiolitis were recruited from the Texas Children's emergency room and intensive care unit from October 2010 to April 2011. Demographic, clinical information, and NW samples were obtained at enrollment. NW samples were analyzed for respiratory viruses, caspase 3/7, and LDH.
A viral pathogen was detected in 91·6% of 131 children, with the most common being respiratory syncytial virus and human rhinovirus. A single infection was found in 61·8% of subjects and co-infection in 29·8%. Children admitted to ICU had significantly higher NW-LDH than children sent home from the ER or admitted to the general floor (P = 0·02). Children infected with RSV had the highest NW-LDH concentration (P = 0·03) compared with other viral infections. NW-LDH and NW-caspase were significantly correlated (r = 0·77, P < 0·0001). The univariate models showed NW-LDH and NW-LDH/NW- caspase 3/7 ratio were directly associated with hospitalization. Mutivariate regression analyses suggested a complex interaction between the biomarkers, demographics, and disposition.
NW-LDH, NW-caspase 3/7 and NW-LDH/NW-caspase 3/7 ratio and their interactions with demographic factors are predictive of bronchiolitis severity and can help distinguish children requiring ICU-level care from those admitted to the general floor, or discharged home from the emergency center.