Elevated Interleukin-6 Levels Predict Clinical Worsening in Pediatric Pulmonary Arterial Hypertension - 22/07/20

Doi : 10.1016/j.jpeds.2020.04.041

Jenny Y. Chen, BA ^1,^{^{∗
Contributed equally.}}, Megan Griffiths, MD ^2,^{^{∗
Contributed equally.}}, Jun Yang, PhD ², Melanie K. Nies, MD ², Rachel L. Damico, MD ³, Catherine E. Simpson, MD ³, R. Dhananjay Vaidya, MD, PhD ⁴, Stephanie Brandal, MS ², D. Dunbar Ivy, MD ⁵, Eric D. Austin, MD ⁶, William C. Nichols, PhD ⁷, Michael W. Pauciulo, BS ⁷, Katie Lutz, BS ⁷, Erika B. Rosenzweig, MD ⁸, Russel Hirsch, MD ⁹, Delphine Yung, MD ¹⁰, Allen D. Everett, MD ^2,^⁎
¹ Johns Hopkins University School of Medicine, Baltimore, MD
² Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
³ Department of Anesthesia and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
⁴ Department of Internal Medicine, Johns Hopkins University, Baltimore, MD
⁵ Department of Pediatric Cardiology, Children's Hospital Colorado, Denver, CO
⁶ Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
⁷ Division of Human Genetics, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
⁸ Division of Pediatric Cardiology, Department of Pediatrics, Columbia University, New York City, NY
⁹ Division of Pediatric Cardiology, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
¹⁰ Division of Pediatric Cardiology, Department of Pediatrics, University of Washington, Seattle, WA

^∗Reprint requests: Allen D. Everett, MD, Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University, 1800 Orleans St, Room M2303, Baltimore, MD 21287.Division of Pediatric CardiologyDepartment of PediatricsJohns Hopkins University1800 Orleans StRoom M2303BaltimoreMD21287

Abstract

Objective

To assess whether circulating interleukin-6 (IL-6) is associated with measures of disease severity and clinical worsening in pediatric pulmonary arterial hypertension (PAH).

Study design

IL-6 was measured by enzyme-linked immunosorbent assay in serum samples from a cross-sectional cohort from the National Heart, Lung, and Blood Institute Pulmonary Arterial Hypertension Biobank (n = 175) and a longitudinal cohort from Children's Hospital Colorado (CHC) (n = 61). Associations between IL-6, disease severity, and outcomes were studied with regression and Kaplan–Meier analysis.

Results

In analyses adjusted for age and sex, each log-unit greater IL-6 was significantly associated in the Pulmonary Arterial Hypertension Biobank cohort with greater pulmonary vascular resistance indices, lower odds of having idiopathic PAH or treatment with prostacyclin, and greater odds of having PAH associated with a repaired congenital shunt. In the CHC cohort, each log-unit greater IL-6 was significantly associated with greater mean pulmonary arterial pressure over time. Kaplan–Meier analysis in the CHC cohort revealed that IL-6 was significantly associated with clinical worsening (a composite score of mortality, transplant, or palliative surgery) (P = .037).

Conclusions

IL-6 was significantly associated with worse hemodynamics at baseline and over time and may be associated with clinical worsening. IL-6 may provide a less-invasive method for disease monitoring and prognosis in pediatric PAH as well as a potential therapeutic target.

Le texte complet de cet article est disponible en PDF.

Abbreviations : 6MWD, APAH, APAH-CHD, CHC, IL-6, IPAH, IV/SQ, mPAP, PAH, PAHB, PCWP, PVRI, RHC

Plan

Funding and conflict of interest statements available in the Appendix (www.jpeds.com).

Export

Vol 223

P. 164 - août 2020 Retour au numéro

Article précédent

50 Years Ago in The Journal of Pediatrics : Amblyopia Screening: An Update
Jose M. Gonzalez, Mariana Urdapilleta

| Article suivant

50 Years Ago in The Journal of Pediatrics : The Cause of Spasmus Nutans and Congenital Nystagmus: Frozen in Time
Shannon Beres

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

Elevated Interleukin-6 Levels Predict Clinical Worsening in Pediatric Pulmonary Arterial Hypertension - 22/07/20

Abstract

Objective

Study design

Results

Conclusions

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL