期刊
CLINICAL INFECTIOUS DISEASES
卷 73, 期 9, 页码 E2665-E2672出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1700
关键词
glycation end products; advanced; bronchiolitis; pediatrics; cohort; mediation; asthma
资金
- NIH [R01 AI-127507, UG3/UH3 OD-023253, R01 AI-134940, R01 AI-137091, K12 HL1199944]
Serum sRAGE levels are inversely associated with acute and chronic morbidities of bronchiolitis, including recurrent wheeze. Higher presenting sRAGE levels are associated with lower risk of intensive care and significantly lower rate of recurrent wheeze. The effect of sRAGE on development of recurrent wheeze is potentially driven through pathways other than acute severity of bronchiolitis.
Background. Although bronchiolitis contributes to substantial acute (eg, intensive care use) and chronic (eg, recurrent wheeze) morbidities in young children, the pathobiology remains uncertain. We examined the associations of serum soluble receptor for advanced glycation end products (sRAGE) with acute and chronic morbidities of bronchiolitis including recurrent wheeze. Methods. A multicenter, multiyear, cohort study of infants hospitalized for bronchiolitis was analyzed. We measured the serum sRAGE level at hospitalization and its association with intensive care use (use of mechanical ventilation and/or admission to the intensive care unit) and development of recurrent wheeze by age 3 years. We performed causal mediation analysis to estimate indirect (mediation) and direct effects of sRAGE on recurrent wheeze. Results. In 886 infants with bronchiolitis, the median age was 2.9 months. Overall, 15% underwent intensive care and 32% developed recurrent wheeze. In multivariable modeling adjusting for 11 confounders, a higher presenting sRAGE level was associated with lower risk of intensive care (odds ratio for each 1-log increment, 0.39; 95% confidence interval [CI],.16 -. 91; P =.03) and significantly lower rate of recurrent wheeze (hazard ratio [HR], 0.58; 95% CI,.36 -.94; P =.03). In mediation analysis, the direct effect was significant (HR, 0.60; 95% CI,.37 -.97; P =.04), while the indirect effect was not (P =.30). Conclusions. Serum sRAGE levels were inversely associated with acute and chronic morbidities of bronchiolitis. The effect of sRAGE on development of recurrent wheeze is potentially driven through pathways other than acute severity of bronchiolitis.
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