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Nauwelaerts SJD, Van Goethem N, De Cremer K, Sierra NB, Vercauteren J, Stroobants C, Bernard A, Nawrot T, Roosens NHC, De Keersmaecker SCJ. Noninvasive integrative approach applied to children in the context of recent air pollution exposure demonstrates association between fractional exhaled nitric oxide (FeNO) and urinary CC16. ENVIRONMENTAL RESEARCH 2023; 216:114441. [PMID: 36191620 DOI: 10.1016/j.envres.2022.114441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Exposure to the air pollutant particulate matter (PM) is associated with increased risks of respiratory diseases and enhancement of airway inflammation in children. In the context of large scale air pollution studies, it can be challenging to measure fractional exhaled nitric oxide (FeNO) as indicator of lung inflammation. Urinary CC16 (U-CC16) is a potential biomarker of increased lung permeability and toxicity, increasing following short-term PM2.5 exposure. The single nucleotide polymorphism (SNP) CC16 G38A (rs3741240) affects CC16 levels and respiratory health. Our study aimed at assessing the use of U-CC16 (incl. CC16 G38A from saliva) as potential alternative for FeNO by investigating their mutual correlation in children exposed to PM. Samples from a small-scale study conducted in 42 children from urban (n = 19) and rural (n = 23) schools examined at two time points, were analysed. When considering recent (lag1) low level exposure to PM2.5 as air pollution measurement, we found that U-CC16 was positively associated with FeNO (β = 0.23; 95% CI [-0.01; 0.47]; p = 0.06) in an adjusted analysis using a linear mixed effects model. Further, we observed a positive association between PM2.5 and FeNO (β = 0.56; 95% CI [0.02; 1.09]; p = 0.04) and higher FeNO in urban school children as compared to rural school children (β = 0.72; 95% CI [0.12; 1.31]; p = 0.02). Although more investigations are needed, our results suggest that inflammatory responses evidenced by increased FeNO are accompanied by potential increased lung epithelium permeability and injury, evidenced by increased U-CC16. In future large scale studies, where FeNO measurement is less feasible, the integrated analysis of U-CC16 and CC16 G38A, using noninvasive samples, might be a suitable alternative to assess the impact of air pollution exposure on the respiratory health of children, which is critical for policy development at population level.
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Affiliation(s)
- Sarah J D Nauwelaerts
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium; Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Brussels, Belgium
| | - Nina Van Goethem
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Koen De Cremer
- Platform Chromatography and Mass Spectrometry, Sciensano, Brussels, Belgium
| | | | | | - Christophe Stroobants
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium
| | - Alfred Bernard
- Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Brussels, Belgium
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590, Diepenbeek, Belgium; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Nancy H C Roosens
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
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Nauwelaerts SJD, Van Goethem N, Ureña BT, De Cremer K, Bernard A, Saenen ND, Nawrot TS, Roosens NHC, De Keersmaecker SCJ. Urinary CC16, a potential indicator of lung integrity and inflammation, increases in children after short-term exposure to PM 2.5/PM 10 and is driven by the CC16 38GG genotype. ENVIRONMENTAL RESEARCH 2022; 212:113272. [PMID: 35439460 DOI: 10.1016/j.envres.2022.113272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
Particular matter (PM) exposure is a big hazard for public health, especially for children. Serum CC16 is a well-known biomarker of respiratory health. Urinary CC16 (U-CC16) can be a noninvasive alternative, albeit requiring adequate adjustment for renal handling. Moreover, the SNP CC16 G38A influences CC16 levels. This study aimed to monitor the effect of short-term PM exposure on CC16 levels, measured noninvasively in schoolchildren, using an integrative approach. We used a selection of urine and buccal DNA samples from 86 children stored in an existing biobank. Using a multiple reaction monitoring method, we measured U-CC16, as well as RBP4 (retinol binding protein 4) and β2M (beta-2-microglobulin), required for adjustment. Buccal DNA samples were used for CC16 G38A genotyping. Linear mixed-effects models were used to find relevant associations between U-CC16 and previously obtained data from recent daily PM ≤ 2.5 or 10 μm exposure (PM2.5, PM10) modeled at the child's residence. Our study showed that exposure to low PM at the child's residence (median levels 18.9 μg/m³ (PM2.5) and 23.6 μg/m³ (PM10)) one day before sampling had an effect on the covariates-adjusted U-CC16 levels. This effect was dependent on the CC16 G38A genotype, due to its strong interaction with the association between PM levels and covariates-adjusted U-CC16 (P = 0.024 (PM2.5); P = 0.061 (PM10)). Only children carrying the 38GG genotype showed an increase of covariates-adjusted U-CC16, measured 24h after exposure, with increasing PM2.5 and PM10 (β = 0.332; 95% CI: 0.110 to 0.554 and β = 0.372; 95% CI: 0.101 to 0.643, respectively). To the best of our knowledge, this is the first study using an integrative approach to investigate short-term PM exposure of children, using urine to detect early signs of pulmonary damage, and taking into account important determinants such as the genetic background and adequate adjustment of the measured biomarker in urine.
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Affiliation(s)
- Sarah J D Nauwelaerts
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium; Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Woluwe, Brussels, Belgium
| | - Nina Van Goethem
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, Université catholique de Louvain, Belgium
| | - Berta Tenas Ureña
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
| | - Koen De Cremer
- Platform Chromatography and Mass Spectrometry, Sciensano, Brussels, Belgium
| | - Alfred Bernard
- Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Woluwe, Brussels, Belgium
| | - Nelly D Saenen
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Nancy H C Roosens
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
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Nauwelaerts SJD, De Cremer K, Bustos Sierra N, Gand M, Van Geel D, Delvoye M, Vandermassen E, Vercauteren J, Stroobants C, Bernard A, Saenen ND, Nawrot TS, Roosens NHC, De Keersmaecker SCJ. Assessment of the Feasibility of a Future Integrated Larger-Scale Epidemiological Study to Evaluate Health Risks of Air Pollution Episodes in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148531. [PMID: 35886381 PMCID: PMC9323067 DOI: 10.3390/ijerph19148531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 02/07/2023]
Abstract
Air pollution exposure can lead to exacerbation of respiratory disorders in children. Using sensitive biomarkers helps to assess the impact of air pollution on children’s respiratory health and combining protein, genetic and epigenetic biomarkers gives insights on their interrelatedness. Most studies do not contain such an integrated approach and investigate these biomarkers individually in blood, although its collection in children is challenging. Our study aimed at assessing the feasibility of conducting future integrated larger-scale studies evaluating respiratory health risks of air pollution episodes in children, based on a qualitative analysis of the technical and logistic aspects of a small-scale field study involving 42 children. This included the preparation, collection and storage of non-invasive samples (urine, saliva), the measurement of general and respiratory health parameters and the measurement of specific biomarkers (genetic, protein, epigenetic) of respiratory health and air pollution exposure. Bottlenecks were identified and modifications were proposed to expand this integrated study to a higher number of children, time points and locations. This would allow for non-invasive assessment of the impact of air pollution exposure on the respiratory health of children in future larger-scale studies, which is critical for the development of policies or measures at the population level.
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Affiliation(s)
- Sarah J. D. Nauwelaerts
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
- Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, 1200 Brussels, Belgium;
| | - Koen De Cremer
- Platform Chromatography and Mass Spectrometry, Sciensano, 1050 Brussels, Belgium;
| | | | - Mathieu Gand
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
| | - Dirk Van Geel
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
| | - Maud Delvoye
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
| | - Els Vandermassen
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
| | - Jordy Vercauteren
- Unit Air, Vlaamse Milieumaatschappij, 2000 Antwerpen, Belgium; (J.V.); (C.S.)
| | | | - Alfred Bernard
- Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, 1200 Brussels, Belgium;
| | - Nelly D. Saenen
- Centre for Environmental Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (N.D.S.); (T.S.N.)
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (N.D.S.); (T.S.N.)
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
| | - Nancy H. C. Roosens
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
| | - Sigrid C. J. De Keersmaecker
- Transversal Activities in Applied Genomics, Sciensano, 1050 Brussels, Belgium; (S.J.D.N.); (M.G.); (D.V.G.); (M.D.); (E.V.); (N.H.C.R.)
- Correspondence:
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Mao Y, Feng H. Vitamin D3 alleviates cigarette smoke extract‑mediated epithelial‑mesenchymal transition and fibrogenesis by upregulating CC16 expression in bronchial epithelial cells. Exp Ther Med 2022; 23:357. [PMID: 35493433 PMCID: PMC9019742 DOI: 10.3892/etm.2022.11284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Vitamin D3 supplementation has been previously reported to inhibit the occurrence and development of chronic obstructive pulmonary disease (COPD). However, the underlying mechanism remains unclear. Epithelial-mesenchymal transition (EMT) and fibrogenesis have been associated with the development of COPD. The aim of the present study was to investigate the potential effects and mechanism of vitamin D3 in an in vitro model of cigarette smoke (CS)-induced EMT and fibrosis, with specific focus on the role of club cell protein 16 (CC16). CS extract (CSE) at different concentrations (5, 10 and 20%) was used to treat 16-HBE cells to induce EMT and fibrogenesis following which they were treated with vitamin D3. Subsequently, the 20% CSE group was selected for further experiments, where 16-HBE cells were divided into the following five groups: The control group; the CSE group; the low-dose vitamin D3 group (250 nM); the medium-dose vitamin D3 group (500 nM); and the high-dose vitamin D3 group (1,000 nM). Western blot analysis was used to detect the protein expression levels of the EMT-related proteins E-cadherin, N-cadherin, Slug and α-SMA, fibrogenesis-related proteins collagen Ⅳ and fibronectin 1, proteins involved in the TGF-β1/SMAD3 signaling pathway and CC16. Immunofluorescence was used to measure the protein expression levels of E-cadherin, N-cadherin and collagen Ⅳ. Specific CC16 knockdown was performed using short hairpin RNA transfection to investigate the role of CC16. The results of the present study found that vitamin D3 could increase the protein expression level of CC16 to inhibit the activation of the TGF-β1/SMAD3 signaling pathway; thereby reducing the 20% increase in CSE-induced EMT- and fibrogenesis-related protein expression levels. Following CC16 knockdown, the inhibitory effects of vitamin D3 on EMT- and fibrogenesis-related protein expression were partially reversed. To conclude, these results suggest that vitamin D3 can inhibit the protein expression levels of EMT- and fibrogenesis-related proteins induced by CSE, at least partially through the function of CC16. These findings are expected to provide novel theoretical foundations and ideas for the pathogenesis and treatment of COPD.
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Affiliation(s)
- Yajun Mao
- Rehabilitation Medicine Department, The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China
| | - Hong Feng
- Respiratory Department, The Fourth Hospital of Baotou City, Baotou, Inner Mongolia Autonomous Region 014030, P.R. China
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Mootz M, Jakwerth CA, Schmidt‐Weber CB, Zissler UM. Secretoglobins in the big picture of immunoregulation in airway diseases. Allergy 2022; 77:767-777. [PMID: 34343347 DOI: 10.1111/all.15033] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022]
Abstract
The proteins of the secretoglobin (SCGB) family are expressed by secretory tissues of barrier organs. They are embedded in immunoregulatory and anti-inflammatory processes of airway diseases. This review particularly illustrates the immune regulation of SCGBs by cytokines and their implication in the pathophysiology of airway diseases. The biology of SCGBs is a complex topic of increasing importance, as they are highly abundant in the respiratory tract and can also be detected in malignant tissues and as elements of immune control. In addition, SCGBs react to cytokines, they are embedded in Th1 and Th2 immune responses, and they are expressed in a manner dependent on cell maturation. The big picture of the SCGB family identifies these factors as critical elements of innate immune control at the epithelial barriers and highlights their potential for diagnostic assessment of epithelial activity. Some members of the SCGB family have so far only been superficially examined, but have high potential for translational research.
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Affiliation(s)
- Martine Mootz
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
- Technical University of Munich (TUM)TUM School of MedicineKlinikum Rechts der Isar Munich Germany
| | - Constanze A. Jakwerth
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
| | - Carsten B. Schmidt‐Weber
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
| | - Ulrich M. Zissler
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Center MunichGerman Research Center for Environmental Health (HMGU) Munich Germany
- Member of the German Center of Lung Research (DZL)CPC‐M Munich Germany
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Development of a multiplex mass spectrometry method for simultaneous quantification of urinary proteins related to respiratory health. Sci Rep 2021; 11:10107. [PMID: 33980897 PMCID: PMC8115669 DOI: 10.1038/s41598-021-89068-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/16/2021] [Indexed: 02/03/2023] Open
Abstract
Respiratory health of children is a health priority. Club cell protein (CC16) is an interesting biomarker of lung diseases and adverse effects towards the airway epithelium integrity. Osteopontin (OPN) and nuclear factor-kappa B (NF-κB) also play a role in respiratory health. The use of urine as biomarker source is useful in studies involving children but necessitates proper adjustment for physiological confounders influencing the urinary excretion, potentially characterized with beta-2-microglobulin (β2M), retinol binding protein 4 (RBP4) or myoglobin (MYO), as well as adjustment for possible renal dysfunction, characterized by human serum albumin (HSA). The simultaneous quantification of all these proteins in urine could facilitate children's health monitoring. A multiple reaction monitoring method (MRM) was developed and validated for the relative quantification of the seven mentioned urinary proteins. A total of nine proteotypic peptides were selected and used for the relative quantification of the seven proteins. The MRM method was completely validated for all proteins and partially for OPN. LOQ's ranged from 0.3 to 42.8 ng/ml, a good reproducibility and a good linearity were obtained across the analytical measurement range (r2 > 0.98). The method yielded varying correlations (r2 of 0.78, 0.71, 0.34 and 0.15 for CC16, β2M, RBP4 and HSA respectively) with available immunoassay data. It also allowed the identification and successful quantification of β2M and RBP4 as a protein candidate for adjustment of renal handling and dysfunction. All proteins were detected in the urine samples except for MYO and NF-κB. Our validated MRM-method is able to simultaneously quantify in urine biomarkers of airway epithelium integrity and biomarkers of variation in renal function and urinary dilution. This will allow to investigate further in future studies if urine can be used as a good surrogate source for biomarkers of airway epithelium integrity, and to understand the complex relationship between cause and effect in children's respiratory health monitoring.
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Almuntashiri S, Zhu Y, Han Y, Wang X, Somanath PR, Zhang D. Club Cell Secreted Protein CC16: Potential Applications in Prognosis and Therapy for Pulmonary Diseases. J Clin Med 2020; 9:jcm9124039. [PMID: 33327505 PMCID: PMC7764992 DOI: 10.3390/jcm9124039] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/03/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023] Open
Abstract
Club cell secretory protein (CC16) is encoded by the SCGB1A1 gene. It is also known as CC10, secretoglobin, or uteroglobin. CC16 is a 16 kDa homodimeric protein secreted primarily by the non-ciliated bronchial epithelial cells, which can be detected in the airways, circulation, sputum, nasal fluid, and urine. The biological activities of CC16 and its pathways have not been completely understood, but many studies suggest that CC16 has anti-inflammatory and anti-oxidative effects. The human CC16 gene is located on chromosome 11, p12-q13, where several regulatory genes of allergy and inflammation exist. Studies reveal that factors such as gender, age, obesity, renal function, diurnal variation, and exercise regulate CC16 levels in circulation. Current findings indicate CC16 not only may reflect the pathogenesis of pulmonary diseases, but also could serve as a potential biomarker in several lung diseases and a promising treatment for chronic obstructive pulmonary disease (COPD). In this review, we summarize our current understanding of CC16 in pulmonary diseases.
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Affiliation(s)
- Sultan Almuntashiri
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA; (S.A.); (Y.Z.); (Y.H.); (P.R.S.)
| | - Yin Zhu
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA; (S.A.); (Y.Z.); (Y.H.); (P.R.S.)
| | - Yohan Han
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA; (S.A.); (Y.Z.); (Y.H.); (P.R.S.)
| | - Xiaoyun Wang
- Center for Vaccines and Immunology, University of Georgia, Athens, GA 30602, USA;
| | - Payaningal R. Somanath
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA; (S.A.); (Y.Z.); (Y.H.); (P.R.S.)
- Department of Medicine, Augusta University, Augusta, GA 30912, USA
| | - Duo Zhang
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA; (S.A.); (Y.Z.); (Y.H.); (P.R.S.)
- Correspondence: ; Tel.: +1-706-721-6491; Fax: +1-706-721-3994
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Corrigendum. Pediatr Pulmonol 2020; 55:1074. [PMID: 32167683 PMCID: PMC8097529 DOI: 10.1002/ppul.24705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Egron C, Labbé A, Rochette E, Mulliez A, Bernard A, Flore A. Urinary club cell protein 16 (CC16): Utility of its assay during acute bronchiolitis. Pediatr Pulmonol 2020; 55:490-495. [PMID: 31770479 PMCID: PMC7167874 DOI: 10.1002/ppul.24584] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 11/10/2019] [Indexed: 01/20/2023]
Abstract
Acute bronchiolitis is responsible for high morbidity in infants. Club cell protein 16 kDa (CC16) is a major pneumoprotein secreted by club cells of the bronchial epithelium and eliminated by the renal pathway. CC16 seems to be a biomarker of epithelial damage in asthma. However, its value as a marker of acute bronchiolitis severity and later recurrent wheezing are uncertain, especially the value of its urinary assay for this purpose. A prospective, observational, analytical study was conducted at Clermont-Ferrand University Hospital to correlate serum CC16 level with clinical severity of bronchiolitis in hospitalized infants aged less than 1 year. We analyzed correlations between serum and urinary CC16, CC16 levels and Wainwright score, immediate morbidity due to bronchiolitis, causal viruses, and recurrent wheezing 1 year after inclusion. In 166 infants, serum CC16 did not correlate with acute bronchiolitis severity (P = .49), but urinary CC16 did (P < .001). In multivariate analysis, urinary CC16 correlated mainly with urinary retinol binding protein (RBP; r = 0.70; P < .001). The logCC16u/logRBPu ratio correlated significantly with severity (P = .02). CC16 levels were not correlated with recurrent wheezing at 1 year. Urinary CC16 could be a useful biomarker in acute bronchiolitis for specific indications. This noninvasive assay would be particularly useful in the young infant population. Several factors must be taken into account in its interpretation, mainly tubular function. Further studies are needed to assess these factors.
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Affiliation(s)
- Carole Egron
- Department of Pediatrics, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - André Labbé
- Department of Pediatrics, CHU Clermont-Ferrand, University Clermont Auvergne, Clermont-Ferrand, France
| | - Emmanuelle Rochette
- Department of Clinical Research for Children (CRECHE) at CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Aurélien Mulliez
- Department of Clinical Research and Innovation at CHU Clermont-Ferrand, Hospital Engineer, Clermont-Ferrand, France
| | - Alfred Bernard
- Louvain Center of Toxicology and Applied Pharmacology, Catholic University of Louvain, Brussels, Belgium
| | - Amat Flore
- Center of Asthma and Allergy, AP-HP, Groupe hospitalier Trousseau-La Roche Guyon, Pierre and Marie Curie University, Paris, France
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