Lactoferrin (LF) and inter-alpha inhibitor protein (IaIp) are being investigated as potential biomarkers for differentiating serious bacterial infections in hospitalized pediatric populations, according to abstracts from two related pilot studies presented at the Pediatric Academic Societies annual meeting (Washington, D.C.; May 4-7). LF and IaIp are known to play a role in infection-related inflammation and its modulation, but they are not well studied in pediatric patients. In the first study the Brown University researchers prospectively collected data from 40 children admitted to a tertiary children’s hospital for infectious illnesses. Cases (n=28; mean age 6.7 years) had positive cultures or imaging or a discharge diagnoses consistent with bacterial disease, whereas controls (n=12; mean age 2.4 years) were negative for all three. Values of white blood count (WBC), absolute neutrophil count (ANC), procalcitonin (PCT), and LF were all significantly higher in the cases versus the controls. IaIp values approached, but did not reach, significance. IaIp values for both groups were lower than literature-based healthy control values. In the second study, the same group of researchers sought to determine whether children with pathology-confirmed appendicitis (16 cases with mean age 10 years) had significant changes to LF or IaIp compared to children presenting with […]
Lactoferrin (LF) and inter-alpha inhibitor protein (IaIp) are being investigated as potential biomarkers for differentiating serious bacterial infections in hospitalized pediatric populations, according to abstracts from two related pilot studies presented at the Pediatric Academic Societies annual meeting (Washington, D.C.; May 4-7). LF and IaIp are known to play a role in infection-related inflammation and its modulation, but they are not well studied in pediatric patients.
In the first study the Brown University researchers prospectively collected data from 40 children admitted to a tertiary children’s hospital for infectious illnesses. Cases (n=28; mean age 6.7 years) had positive cultures or imaging or a discharge diagnoses consistent with bacterial disease, whereas controls (n=12; mean age 2.4 years) were negative for all three. Values of white blood count (WBC), absolute neutrophil count (ANC), procalcitonin (PCT), and LF were all significantly higher in the cases versus the controls. IaIp values approached, but did not reach, significance. IaIp values for both groups were lower than literature-based healthy control values.
In the second study, the same group of researchers sought to determine whether children with pathology-confirmed appendicitis (16 cases with mean age 10 years) had significant changes to LF or IaIp compared to children presenting with abdominal pain without appendicitis or any other surgical emergency (eight controls with mean ages 11.3 years). Values for WBC, ANC, and PCT were significantly higher in kids with pathology-confirmed appendicitis compared to controls. Values for LF and IaIp approached significance.
“There are increasingly good diagnostics for the detection of viruses, but they don’t assure us that it is not a concomitant bacterial infection,” co-author Russell J. McCulloh, M.D., an infectious disease fellow at Brown University in Providence, R.I., tells DTTR. His group will continue to pursue these biomarkers to identify the proper diagnostic mix. Future studies will be conducted in a research network of emergency departments, rather than with admitted patients, and will differentiate bacterial disease states (pneumonia, nephritis, cellulitis, etc.).
