The Role of TRAIL, IP-10 and MxA in Distinguishing Acute Community-acquired Viral and Bacterial Pneumonia in Children

Abstract

Objective

Acute paediatric community-acquired pneumonia (pedCAP) represents a significant burden on child health and highlights the need for accurate diagnostic tools. This study aimed to differentiate between acute community-acquired viral and bacterial pedCAP using TRAIL, IP-10, and MxA markers.

Material and Method

The study a single-center prospective study was conducted between January 2019 to January 2020. During the follow-up period, 315 patients with paediatric community-acquired pneumonia were followed up. The analysis was performed with 52 patients aged 5 years and younger in whom pathogens were detected. 24 control groups were also included to see the change of markers in intact subjects. The patients’ medical history and samples were obtained upon hospital admission or within the first day.

Results

The mean values of MxA, TRAIL, and IP-10 differed significantly among all three groups (all p values p<0.01). The ROC analysis indicated that serum MxA, TRAIL, and IP-10 parameters had diagnostic value in predicting the differentiation of viral pedCAP from bacterial pedCAP .

Conclusion

The TRAIL, MxA, and IP-10 markers have diagnostic value in distinguishing viral pneumonia and bacterial pneumonia. Among these markers, MxA exhibits the highest sensitivity. High levels of MxA, TRAIL and IP-10 in combination with low C-reactive protein (CRP), procalcitonin (PCT) and neutrophil lymphocyte ratio (NLR) values to differentiate viral from bacterial pedCAP will significantly contribute to the accurate identification of viral LRTI.

Zusammenfassung

Zielsetzung

Die akute pädiatrische ambulant erworbene Lungenentzündung (pedCAP) stellt eine erhebliche Belastung für die Gesundheit von Kindern dar und unterstreicht den Bedarf an präzisen Diagnoseinstrumenten. Diese Studie zielte darauf ab, anhand von TRAIL-, IP-10- und MxA-Markern zwischen akuter ambulant erworbener viraler und bakterieller pedCAP zu unterscheiden.

Material und Methode

Die Studie, eine einzentrale prospektive Studie, wurde zwischen Januar 2019 und Januar 2020 durchgeführt. Während des Nachbeobachtungszeitraums wurden 315 Patienten mit pädiatrischer ambulant erworbener Pneumonie nachbeobachtet. Die Analyse wurde mit 52 Patienten im Alter von 5 Jahren und jünger durchgeführt, bei denen Erreger nachgewiesen wurden. Außerdem wurden 24 Kontrollgruppen einbezogen, um die Veränderung der Marker bei unverletzten Personen zu untersuchen. Die Anamnese der Patienten und die Proben wurden bei der Aufnahme ins Krankenhaus oder innerhalb des ersten Tages entnommen.

Ergebnisse

Die Mittelwerte von MxA, TRAIL und IP-10 unterschieden sich signifikant zwischen allen drei Gruppen (alle p-Werte p<0,01). Die ROC-Analyse zeigte, dass die Serumparameter MxA, TRAIL und IP-10 einen diagnostischen Wert für die Unterscheidung zwischen viraler und bakterieller pedCAP haben.

Schlussfolgerung

Die Marker TRAIL, MxA und IP-10 haben einen diagnostischen Wert bei der Unterscheidung zwischen viraler und bakterieller Lungenentzündung. Unter diesen Markern weist MxA die höchste Sensitivität auf. Hohe MxA-, TRAIL- und IP-10-Werte in Kombination mit niedrigen C-reaktiven Protein- (CRP), Procalcitonin- (PCT) und Neutrophilen-Lymphozyten-Verhältnis- (NLR) Werten zur Unterscheidung von viraler und bakterieller pädiatrischer Pneumonie werden wesentlich zur genauen Identifizierung von viraler LRTI beitragen.

Keywords

myxovirus resistance protein 1 (MxA) - tumor necrosis factor- related - apoptosıs-inducing ligand (TRAIL) - interferon-γ-induced protein (IP-10). - Acute paediatric community-acquired pneumonia (pedCAP)

Schlüsselwörter

Myxovirus-Resistenzprotein 1 - Tumor-Nekrose-Faktor-verwandter - Apoptosıs-induzierender Ligand - Interferon-γ-induziertes Protein - Akute pädiatrische - in der Gemeinschaft erworbene Lungenentzündung (pedCAP)

Publication History

Article published online:
14 July 2025

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