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BackgroundResults 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.MethodsIn this prospective observational study, we enrolled mechanical ventilated ARDS patients categorized into four age groups: 20 neonates ( 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.ResultsLevels 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.ConclusionsAge-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.

Original publication

DOI

10.1186/s13613-019-0529-4

Type

Journal article

Journal

Annals of intensive care

Publication Date

14/05/2019

Volume

9

Addresses

Department of Pediatric Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Keywords

MARS consortium