Lactate dehydrogenase as a marker of nasopharyngeal inflammatory injury during viral upper respiratory infection: implications for acute otitis media

Abstract

BackgroundAcute otitis media (AOM) is a frequent complication of viral upper respiratory tract infection (URI). We hypothesized that severity of nasopharyngeal cellular injury during URI, as measured by lactate dehydrogenase (LDH) concentrations in nasopharyngeal secretions (NPS), is related to AOM complication.MethodsLDH concentrations were determined in NPS samples (n=594) which were collected at the initial visit for URI from 183 children who were followed for development of AOM. A subset of NPS samples (n= 134) were analyzed for interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF) α concentrations.ResultsAOM complication was independently predicted by LDH concentrations (median mU/ml with AOM = 2438 vs. without AOM = 1573, estimate=0.276; P=0.02). LDH effect on AOM development was highest during the first 4 days of URI. LDH concentrations were higher in URIs due to adenoviruses, bocaviruses, and rhinoviruses when compared to virus-negative samples (P <0.05). There was a positive correlation between concentrations of LDH and all cytokines (P< 0.001).ConclusionLDH concentrations in NPS are positively associated with AOM risk, suggesting that the severity of nasopharyngeal inflammatory injury during URI contributes to the development of AOM, and that reduction of inflammatory injury may reduce the risk for AOM.

Determining Persistence of Bocavirus DNA in the Respiratory Tract of Children by Pyrosequencing

“…( 14 ) For HBoV1, increasing evidence supports its role as a respiratory pathogen associated with acute URI, LRI and AOM in young children. ( 4–6, 9, 22, 23, 27, 29 ) In this study, even with lack of serology to confirm acute infection, the absence of other co-infecting respiratory viruses during URI and previously HBoV1-negative samples suggest that new HBoV1 infection is highly associated with AOM following URI (8 out of 15 episodes). This finding supports a possible association with AOM development as described by others.…”

“…( 14, 29 ) Specific respiratory viruses such as RSV, coronavirus, and adenovirus are associated with increased AOM risk. ( 14 ) For HBoV1, increasing evidence supports its role as a respiratory pathogen associated with acute URI, LRI and AOM in young children.…”

Otitis media

“…A serum biomarker risk score has been developed to predict the presence and recovery from AOM caused by nontypeable H. influenzae 226 . In nasopharyngeal secretions, IL-1B and lactate dehydrogenase concentrations were associ ated with the risk for AOM development after viral URTI 65,227 . Together, these data indicate that specific systemic and local biomarkers are helpful in predict ing AOM development, microbiology and clinical outcome.…”

Role of Nasopharyngeal lactate dehydrogenase as a possible economical mass screening test for the detection and segregation of SARS-CoV-2 (COVID-19) cases in India

“…Unlike LDH, these cytokines in themselves do not directly represent cellular injury -the acute-phase cytokines are the mediators of inflammation, whereas LDH is the product of inflammatory injury. [2] LDH is enzyme released in the bronchoalveolar space on damage of cytoplasmic cell membrane. Elevated LDH is also indicator of underlying lung injury and inflammation.…”