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Title: Age-dependent differences in pulmonary host responses in ARDS: a prospective observational cohort study
Authors: Laura R. Schouten
Anton H. van Kaam
Franziska Kohse
Floor Veltkamp
Lieuwe D. Bos
Friso M. de Beer
Roosmarijn T. van Hooijdonk
Janneke Horn
Marleen Straat
Esther Witteveen
Gerie J. Glas
Luuk Wieske
Lonneke A. van Vught
Maryse A. Wiewel
Sarah A. Ingelse
Bart Cortjens
Job B. van Woensel
Albert P. Bos
Thomas Walther
Marcus J. Schultz
Roelie M. Wösten-van Asperen
Friso M. de Beer
Janneke Horn
Arie J. Hoogendijk
Mischa A. Huson
Tom van der Poll
Brendon Scicluna
Marcus J. Schultz
Maryse A. Wiewel
Marc J. Bonten
Olaf L. Cremer
Jos F. Frencken
Kirsten van de Groep
Peter M. Klein Klouwenberg
Maria E. Koster-Brouwer
David S. Ong
Diana M. Verboom
Wilhelmina Children's Hospital
University College Cork
Mahidol University
Amsterdam UMC - University of Amsterdam
University Medicine Greifswald
Keywords: Medicine
Issue Date: 1-Dec-2019
Citation: Annals of Intensive Care. Vol.9, No.1 (2019)
Abstract: © 2019, The Author(s). Background: Results from preclinical studies suggest that age-dependent differences in host defense and the pulmonary renin–angiotensin system (RAS) are responsible for observed differences in epidemiology of acute respiratory distress syndrome (ARDS) between children and adults. The present study compares biomarkers of host defense and RAS in bronchoalveolar lavage (BAL) fluid from neonates, children, adults, and older adults with ARDS. Methods: In this prospective observational study, we enrolled mechanical ventilated ARDS patients categorized into four age groups: 20 neonates (< 28 days corrected postnatal age), 29 children (28 days–18 years), 26 adults (18–65 years), and 17 older adults (> 65 years of age). All patients underwent a nondirected BAL within 72 h after intubation. Activities of the two main enzymes of RAS, angiotensin converting enzyme (ACE) and ACE2, and levels of biomarkers of inflammation, endothelial activation, and epithelial damage were determined in BAL fluid. Results: Levels of myeloperoxidase, interleukin (IL)-6, IL-10, and p-selectin were higher with increasing age, whereas intercellular adhesion molecule-1 was higher in neonates. No differences in activity of ACE and ACE2 were seen between the four age groups. Conclusions: Age-dependent differences in the levels of biomarkers in lungs of ARDS patients are present. Especially, higher levels of markers involved in the neutrophil response were found with increasing age. In contrast to preclinical studies, age is not associated with changes in the pulmonary RAS.
ISSN: 21105820
Appears in Collections:Scopus 2019

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