What's new about circulating biomarkers in pediatric acute lung disease.
What's new about circulating biomarkers in pediatric acute lung disease.
复制标题
小儿急性肺病循环生物标志物的最新动态。
DOI：
10.1007/s00134-016-4304-9
复制
发表时间：
2016
影响因子：
38.9
通讯作者：
Rimensberger,PeterC
中科院分区：
文献类型：
--
作者：
Moreira,Amélia;Sapru,Anil;Rimensberger,PeterC
急性肺病是儿科重症监护病房入院的常见原因，至少有30%需要有创机械通气(MV)[1]。肺泡-毛细血管屏障的破坏和随后的通透性增加是急性肺病本身和/或MV的结果。这会导致蛋白渗漏和炎性介质从肺循环和体循环溢出。成人急性呼吸窘迫综合征(ARDS)患者的循环生物标志物已被广泛研究，但儿科研究的数量有限。儿科强化治疗师经常将成人数据外推到儿科，但儿童急性肺部疾病的发病率、病因和结局存在显著差异，主要与肺部和免疫系统的发育变化有关[2-4]。然而，在儿童中，就像在成人中一样，循环的生物标志物有可能识别有不良预后风险的患者，提高我们对病理生物学的理解，并最终帮助开发更有针对性的治疗方法。我们简要回顾了儿童急性肺病的血浆或血清生物标志物的“新进展”，重点介绍了这一领域的临床应用和未来工作的需要。这些生物标记物可以用病理生理学方法进行分类。
Acute lung disease is a frequent cause of admission in pediatric intensive care units with at least 30% requiring invasive mechanical ventilation (MV)[1]. Disruption of the alveolar-capillary barrier and subsequent increased permeability results from the acute lung disease itself and/or MV. This leads to protein leakage and spillover of inflammatory mediators from and to the pulmonary and systemic circulations. Circulating biomarkers among adult patients with acute respiratory distress syndrome (ARDS) have been extensively studied, but the number of pediatric studies is limited. Pediatric intensivists frequently extrapolate adult data to pediatrics but there are significant differences in incidence, etiology, and outcome of acute lung disease in children, primarily related to developmental changes in the lungs and immune system [2–4]. Nevertheless, circulating biomarkers in children, as in adults, have the potential to identify patients at risk of poor outcomes, to improve our understanding of the pathobiology, and eventually to help to develop more targeted therapies. We present a concise review of “what’s new” in plasma or serum biomarkers of acute lung disease in children, with a focus on clinical utility and need for future work in this area. These biomarkers can be classified in a pathophysiological approach.