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Evaluation of Pentraxin-3 levels in children with multisystem inflammatory syndrome

Published online by Cambridge University Press:  02 December 2024

Dolunay Gürses Open the ORCID record for Dolunay Gürses [Opens in a new window] ,
Münevver Yılmaz Open the ORCID record for Münevver Yılmaz [Opens in a new window] ,
Esin Avcı ,
Merve Oğuz Open the ORCID record for Merve Oğuz [Opens in a new window] ,
Emine Sayın Open the ORCID record for Emine Sayın [Opens in a new window]  and
Selçuk Yüksel Open the ORCID record for Selçuk Yüksel [Opens in a new window]
Dolunay Gürses
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
Münevver Yılmaz*
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
Esin Avcı
Affiliation:
Department of Medical Biochemistry, Faculty of Medicine, Pamukkale University Denizli, Denizli, Turkey
Merve Oğuz
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
Emine Sayın
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
Selçuk Yüksel
Affiliation:
Department of Pediatric Rheumatology, Faculty of Medicine, Onsekiz Mart University Çanakkale, Pamukkale, Turkey
*
Corresponding author: Münevver Yılmaz; Email: [email protected]
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Abstract

Background:

Early recognition of cardiac involvement and prediction of disease prognosis are essential for the management of inflammatory diseases such as multisystem inflammatory syndrome. This study aimed to investigate the role of Pentraxin-3 levels in identifying cardiac involvement and evaluating disease severity in patients with multisystem inflammatory syndrome.

Methods:

The study included 56 multisystem inflammatory syndrome patients and 26 healthy children as a control group. The multisystem inflammatory syndrome group was divided into those with cardiac involvement (n = 34) and those without (n = 22), as well as those with clinically mild-moderate (n = 30) and severe (n = 26) multisystem inflammatory syndrome. Blood samples for measurement of Pentraxin-3 levels were obtained from all patients before treatment and from the healthy controls.

Results:

In the patient group, the mean age was 8.2 ± 4 years (range: 2–17 years), and the male-to-female ratio was 1.8. In the control group, these values were 9.5 ± 3.7 years (range: 2–16 years) and 1.9, respectively (p > 0.05). Plasma Pentraxin-3 levels were significantly higher in multisystem inflammatory syndrome patients compared to controls (7.1 ± 5 ng/mL vs. 2.9 ± 2.1 ng/mL, p = 0.001). Patients with cardiac involvement had a significantly higher median Pentraxin-3 level than those without (5.8 ng/mL vs. 4.1 ng/mL, p = 0.004). Severe disease was also associated with a higher median Pentraxin-3 level compared to mild-moderate disease (6.1 ng/mL vs. 4.4 ng/mL, p = 0.001). Pentraxin-3 level was negatively correlated with left ventricular ejection fraction and positively correlated with B-type natriuretic peptide, troponin.

Conclusion:

Elevated Pentraxin-3 levels in multisystem inflammatory syndrome patients may help predict the clinical course of the disease and cardiac involvement. However, larger-scale prospective studies are needed to further elucidate this.

Keywords

Multisystem inflammatory syndrome in childrenPentraxin-3Cardiac involvement
Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 2 , February 2025 , pp. 317 - 323
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Copyright
© Cambridge University Press, 2024. Published by Cambridge University Press

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References

Santos, MO, Gonçalves, LC, Silva, PAN, et al. Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. J Pediatr (Rio J) 2022; 98: 338–349.CrossRefGoogle ScholarPubMed
Karimi, A, Ghafouri, P, Alilou, S, Rezaei, N, Ashraf Talesh, S, Ashraf, H. Echocardiographic findings in multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19: a systematic review. Iran J Pediatr 2022; 32: e119001.CrossRefGoogle Scholar
Yasuhara, J, Masuda, K, Watanabe, K, et al. Longitudinal cardiac outcomes of multisystem inflammatory syndrome in children: a systematic review and meta-analysis. Pediatr Cardiol 2023; 44: 892–907.CrossRefGoogle ScholarPubMed
Mantovani, A, Garlanda, C, Doni, A, Bottazzi, B. Pentraxins in innate immunity: from C-reactive protein to the long pentraxin PTX3. J Clin Immunol 2008; 28: 1–13.CrossRefGoogle Scholar
Lee, YT, Gong, M, Chau, A, et al. International heath informatics study (IHIS) network. Pentraxin-3 as a marker of sepsis severity and predictor of mortality outcomes: a systematic review and meta-analysis. J Infect 2018; 76: 1–10.CrossRefGoogle ScholarPubMed
Zlibut, A, Bocsan, IC, Agoston-Coldea, L. Pentraxin-3 and endothelial dysfunction. Adv Clin Chem 2019; 91: 163–179.CrossRefGoogle ScholarPubMed
Fornai, F, Carrizzo, A, Forte, M, et al. The inflammatory protein Pentraxin 3 in cardiovascular disease. Immun Ageing 2016; 13: 25.CrossRefGoogle ScholarPubMed
Gürses, D, Oğuz, M, Yilmaz, M, Aybek, H, Akpinar, F. Pentraxin 3 levels and correlation with disease severity in patients with acute rheumatic fever. Arch Rheumatol 2021; 36: 233–243.CrossRefGoogle ScholarPubMed
Ristagno, G, Fumagalli, F, Bottazzi, B, et al. Pentraxin 3 in cardiovascular disease. Front Immunol 2019; 10: 823.CrossRefGoogle ScholarPubMed
Laing, AG, Lorenc, A, Del Molino Del Barrio, I, et al. A dynamic COVID-19 immune signature includes associations with poor prognosis. Nat Med 2020; 26: 1623–1635.CrossRefGoogle ScholarPubMed
Brunetta, E, Folci, M, Bottazzi, B, et al. Macrophage expression and prognostic significance of the long pentraxin PTX3 in COVID-19. Nat Immunol 2021; 22: 19–24.CrossRefGoogle Scholar
Risitano, AM, Mastellos, DC, Huber-Lang, M, et al. Complement as a target in COVID-19? Nat Rev Immunol 2020; 20: 343–344.CrossRefGoogle ScholarPubMed
Syrimi, E, Fennell, E, Richter, A, et al. The immune landscape of SARS-CoV-2-associated multisystem inflammatory syndrome in children (MIS-C) from acute disease to recovery. iScience 2021; 24: 103215.CrossRefGoogle ScholarPubMed
Multisystem infammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) 2020. Accessed 1 March 2022. Available at: https://emergency.cdc.gov/han/2020/han00432.asp.Google Scholar
Multisystem infammatory syndrome in children and adolescents temporally related to COVID-19 2020. Accessed 1 March 2022. Available at: https://www.who.int/news-room/commentaries/detail/multisystem-inflammatorysyndrome-in-children-and-adolescents-with-covid-19.Google Scholar
Leteurtre, S, Duhamel, A, Salleron, J, Grandbastien, B, Lacroix, J, Leclerc, F. Groupe Francophone de Réanimation et d’Urgences Pédiatriques (GFRUP). PELOD-2: an update of the PEdiatric logistic organ dysfunction score. Crit Care Med 2013; 41: 1761–1773.CrossRefGoogle ScholarPubMed
Akkoyun, EB, Most, Z, Katragadda, H, et al. Impact of anakinra use on clinical outcomes in children with moderate or severe multisystem inflammatory syndrome in children: a propensity score matched retrospective cohort study. Pediatr Rheumatol Online 2023; 21: 141.CrossRefGoogle ScholarPubMed
Gutmann, C, Takov, K, Burnap, SA, et al. SARS-CoV-2 RNAemia and proteomic trajectories inform prognostication in COVID-19 patients admitted to intensive care. Nat Commun 2021; 12: 3406.CrossRefGoogle ScholarPubMed
Deban, L, Russo, RC, Sironi, M, et al. Regulation of leukocyte recruitment by the long pentraxin PTX3. Nat Immunol 2010; 11: 328–334.CrossRefGoogle ScholarPubMed
Deban, L, Jarva, H, Lehtinen, MJ, et al. Binding of the long pentraxin PTX3 to factor H: interacting domains and function in the regulation of complement activation. J Immunol 2008; 181: 8433–8440.CrossRefGoogle Scholar
Latini, R, Maggioni, AP, Peri, G, et al. Lipid assessment trial Italian network (LATIN) investigators. Prognostic significance of the long pentraxin PTX3 in acute myocardial infarction. Circulation 2004; 110: 2349–2354.CrossRefGoogle Scholar
Polat, N, Yildiz, A, Alan, S, Toprak, N. Association of pentraxin-3 with the severity of rheumatic mitral valve stenosis. Acta Cardiol 2015; 70: 409–4013.CrossRefGoogle ScholarPubMed
Naito, Y, Tsujino, T, Akahori, H, et al. Increase in tissue and circulating pentraxin3 levels in patients with aortic valve stenosis. Am Heart J 2010; 160: 685–689.CrossRefGoogle ScholarPubMed
Nebuloni, M, Pasqualini, F, Zerbi, P, et al. PTX3 expression in the heart tissues of patients with myocardial infarction and infectious myocarditis. Cardiovasc Pathol 2011; 20: e27–35.CrossRefGoogle ScholarPubMed
Suzuki, S, Shishido, T, Funayama, A, et al. Long pentraxin PTX3 exacerbates pressure overload-induced left ventricular dysfunction. PLoS One 2013; 8: e53133.CrossRefGoogle ScholarPubMed
Matsubara, J, Sugiyama, S, Nozaki, T, et al. Pentraxin 3 is a new inflammatory marker correlated with left ventricular diastolic dysfunction and heart failure with normal ejection fraction. J Am Coll Cardiol 2011:, 57:861–869 CrossRefGoogle Scholar
Latini, R, Gullestad, L, Masson, S, et al. Investigators of the controlled rosuvastatin multinational trial in heart failure (CORONA) and GISSI-heart failure (GISSI-HF) trials. () pentraxin-3 in chronic heart failure: the CORONA and GISSI-HF trials. Eur J Heart Fail 2012; 14: 992–999.CrossRefGoogle ScholarPubMed
Ching, LL, Nerurkar, VR, Lim, E, Shohet, RV, Melish, ME, Bratincsak, A. Elevated levels of pentraxin 3 correlate with Neutrophilia and coronary artery dilation during acute kawasaki disease. Front Pediatr 2020; 8: 295.CrossRefGoogle ScholarPubMed
Kitoh, T, Ohara, T, Muto, T, et al. Increased pentraxin 3 levels correlate with IVIG responsiveness and coronary artery aneurysm formation in kawasaki disease. Front Immunol 2021; 12: 624802.CrossRefGoogle ScholarPubMed
Wang, Y, Li, T. Advances in understanding kawasaki disease-related immuno-inflammatory response and vascular endothelial dysfunction. Pediatr Investig 2022; 6: 271–279.CrossRefGoogle ScholarPubMed