Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity

Mehta, Reena; Scheffler, Margaret; Tapia, Lorena; Aideyan, Letisha; Patel, Kirtida D; Jewell, Alan M; Avadhanula, Vasanthi; Mei, Minghua; Garofalo, Roberto P; Piedra, Pedro A

epithelial cell apoptosis is rare in early disease, 22 but predominates in later phases of illness. 23 These results suggest appropriate regulation of the apoptotic response is a complex process and influences the severity of disease. In the multivariable logistic regression analyses, we observed that a one-unit increase in NW-caspase 3/7 activity (log10, U/l) was associated with a decreased likelihood to be admitted to the ACU (OR: 0Á33, 95% CI: 0Á11-0Á96). This was supported with the NW-LDH/NW-caspase 3/7 ratio: children going home from the ER had significantly lower NW-LDH/NW-caspase 3/7 ratios compared with hospitalized children (mean AE SD: 1Á01 AE 0Á39 versus 1Á15 AE 0Á48 P = 0Á03), possibly reflecting a more balanced innate immune response to the viral pathogen. The relationship between NW-LDH and NW-caspase 3/7 is a crucial finding and suggests that NW-LDH or NW-caspase 3/7 alone may Table 3 . Multiple Linear Regression Models for NW-LDH (log10 mU/l), NW-Caspase 3/7 (log10 U/l), and NW-LDH/NW-Caspase 3/7 ratio