Increased β‐glucuronidase activity in bronchoalveolar lavage fluid of children with bacterial lung infection: A case–control study. Issue 8 (14th July 2015)

• Record Type: Journal Article
• Authors: Panagiotopoulou, Evgenia C.; Fouzas, Sotirios; Douros, Konstantinos; Triantaphyllidou, Irene‐Eva; Malavaki, Christina; Priftis, Kostas N.; Karamanos, Nikos K.; Anthracopoulos, Michael B.
• Is Part Of: Respirology. Volume 20:Issue 8(2015)
• Page Start: 1248
• Page End: 1254
• Publication Date: 2015-07-14
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.12596
• Languages: English
• ISSNs: 1323-7799

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="resp12596-sec-0001" sec-type="section"> <title>Background and objective</title> <p>β‐Glucuronidase is a lysosomal enzyme released into the extracellular fluid during inflammation. Increased β‐glucuronidase activity in the cerebrospinal and peritoneal fluid has been shown to be a useful marker of bacterial inflammation. We explored the role of β‐glucuronidase in the detection of bacterial infection in bronchoalveolar lavage fluid (BALF) of paediatric patients.</p> </sec> <sec id="resp12596-sec-0002" sec-type="section"> <title>Methods</title> <p>In this case–control study, % polymorphonuclear cell count (PMN%), β‐glucuronidase activity, interleukin‐8 (IL‐8), tumour necrosis factor‐α (TNF‐α) and elastase were measured in culture‐positive (≥10<sup>4</sup> cfu/mL, C+) and ‐negative (C−) BALF samples obtained from children.</p> </sec> <sec id="resp12596-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 92 BALF samples were analysed. The median β‐glucuronidase activity (measured in nanomoles of 4‐methylumbelliferone (4‐MU)/mL BALF/h) was 246.4 in C+ (interquartile range: 71.2–751) and 21.9 in C− (4.0–40.8) (<italic>P</italic> < 0.001). The levels of TNF‐α and IL‐8 were increased in C+ as compared with C− (5.4 (1.7–12.6) vs 0.7 (0.2–6.2) pg/mL, <italic>P</italic> < 0.001 and 288 (76–4300) vs 287 (89–1566) pg/mL, <italic>P</italic> = 0.042, respectively). Elastase level and PMN% did not differ significantly (50 (21–149) vs 26 (15–59) ng/mL, <italic>P</italic> = 0.051 and 20 (9–40) vs 18 (9–34) %, <italic>P</italic> = 0.674, respectively). The area under the curve of β‐glucuronidase activity (0.856, 95% confidence interval (CI): 0.767–0.920) was higher than that of TNF‐α (0.718; 95% CI: 0.614–0.806; <italic>P</italic> = 0.040), IL‐8 (0.623; 95% CI: 0.516–0.722; <italic>P</italic> = 0.001), elastase (0.645; 95% CI: 0.514–0.761; <italic>P</italic> = 0.008) and PMN% (0.526; 95 % CI: 0.418–0.632; <italic>P</italic> < 0.001).</p> </sec> <sec id="resp12596-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This study demonstrates a significant increase of β‐glucuronidase activity in BALF of children with culture‐positive bacterial inflammation. In our population β‐glucuronidase activity showed superior predictive ability for bacterial lung infection than other markers of inflammation.</p> </sec> </abstract>