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Increased β‐glucuronidase activity in bronchoalveolar lavage fluid of children with bacterial lung infection: A case–control study
Author(s) -
Panagiotopoulou Evgenia C.,
Fouzas Sotirios,
Douros Konstantinos,
Triantaphyllidou IreneEva,
Malavaki Christina,
Priftis Kostas N.,
Karamanos Nikos K.,
Anthracopoulos Michael B.
Publication year - 2015
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12596
Subject(s) - bronchoalveolar lavage , medicine , elastase , glucuronidase , gastroenterology , interquartile range , lung , immunology , tumor necrosis factor alpha , pathology , enzyme , biochemistry , chemistry
Background and objective 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. Methods 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 4 cfu/mL, C +) and ‐negative ( C −) BALF samples obtained from children. Results 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) ( P < 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, P < 0.001 and 288 (76–4300) vs 287 (89–1566) pg/mL, P = 0.042, respectively). Elastase level and PMN % did not differ significantly (50 (21–149) vs 26 (15–59) ng/mL, P = 0.051 and 20 (9–40) vs 18 (9–34) %, P = 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; P = 0.040), IL ‐8 (0.623; 95% CI : 0.516–0.722; P = 0.001), elastase (0.645; 95% CI : 0.514–0.761; P = 0.008) and PMN % (0.526; 95 % CI : 0.418–0.632; P < 0.001). Conclusions 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.