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

The multiple linear regression analyses demonstrated that some interaction effects between demographic variables may be of such significance they can change or predict the severity of bronchiolitis. Our univariate models showed that higher NW-LDH and NW-LDH/NW-caspase 3/7 ratio were strongly linked to more severe illness and hospitalization to the ICU and ACU. Interestingly, when multiple linear models were used for the analyses, the age of the subjects in different levels of disposition also greatly impacted the changes of biomarkers. Those children 4-12 months of age who were hospitalized to the ACU actually had a lower NW-LDH than those sent home whose ages were greater than 12 months, which had the same trend as the results in our previous studies. 13, 14 Thus, the demographic interactions should be considered in conjunction with biomarker data when determining severity of illness. Although this study was not aimed toward explaining these underlying associations, a single variable alone may not be sufficient enough to explain what drives the changes of NW-LDH, NW-caspase 3/7, and NW-LDH/NW-caspase 3/7 ratio.