Skip to main content

Soluble Urokinase Plasminogen Activator Receptor: An Indicator of Pneumonia Severity in Children

  • Chapter
  • First Online:

Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 835))

Abstract

Enhanced level of soluble urokinase plasminogen activator receptor (suPAR) level has been associated with activation of the immune system. It may be a novel biomarker for pneumonia severity, yet data on this subject are limited. In the present study we seek to determine the suPAR level in hospitalized children with community-acquired pneumonia (CAP), its correlation with pneumonia severity, and to compare the suPAR level between pneumonia and healthy conditions. The study encompassed a total of 596 children: 447 with pneumonia and 119 healthy. suPAR was measured in 227 out of the 447 pneumonia patients and in all healthy subjects. We used clinical indicators (fever, time for defeverscence, heart and breath rate, saturation, and length of antibiotic treatment and of hospitalization) and laboratory indicators (CRP, procalcitonin, white blood cell count, and sodium) to assess the CAP severity. The finding were that the suPAR concentration in children with pneumonia was significantly higher (median 7.11 ng/mL) than in healthy individuals (4.68 ng/mL). We found a positive correlation between the suPAR and the following factors: fever, time for defeverscence, length of hospital stay, and elevated CRP and procalcitonin levels. There was a reverse correlation with sodium concentration and capillary blood saturation. Moreover, the suPAR level was significantly higher in children with a severe course of pneumonia compared with those having non-severe pneumonia (7.79 vs. 6.87 ng/mL; p = 0.006). In conclusion, suPAR elevation is observed in pneumonia and may reflect its severity.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Backes Y, van der Sluijs KF, Mackie DP, Tacke F, Koch A, Tenhunen JJ, Schultz MJ (2012) Usefulness of suPAR as a biological marker in patients with systemic inflammation or infection: asystematic review. Intensive Care Med 38:1418–1428

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • De Witte H, Sweep F, Brunner N, Heuvel J, Beex L, Grebenschikov N, Benraad T (1998) Complexes between urokinase-type plasminogen activator and its receptor in blood as determined by enzyme-linked immunosorbent assay. Int J Cancer 77:236–242

    Article  PubMed  Google Scholar 

  • Eugen-Olsen J, Gustafson P, Sidenius N, Fischer TK, Parner J, Aaby P, Gomes VF, Lisse I (2002) The serum level of soluble urokinase receptor is elevated in tuberculosis patients and predicts mortality during treatment: a community study from Guinea-Bissau. Int J Tuberc Lung Dis 6:686–692

    CAS  PubMed  Google Scholar 

  • Garcia-Monco JC, Coleman JL, Benach JL (2002) Soluble urokinase receptor (uPAR, CD87) is present in serum and cerebrospinal fluid in patients with neurologic diseases. J Neuroimmunol 129:216–223

    Article  CAS  PubMed  Google Scholar 

  • Gyetko MR, Sud S, Kendall T, Fuller JA, Newstead MW, Standiford TJ (2000) Urokinase receptor-deficient mice have impaired neutrophil recruitment in response to pulmonary Pseudomonas aeruginosa infection. J Immunol 165:1513–1519

    Article  CAS  PubMed  Google Scholar 

  • Gyetko MR, Aizenberg D, Mayo-Bond L (2004) Urokinase-deficient and urokinase receptor-deficient mice have impaired neutrophil antimicrobial activation in vitro. J Leukoc Biol 76:648–656

    Article  CAS  PubMed  Google Scholar 

  • Huttunen R, Syrjanen J, Vuento R, Hurme M, Huhtala H, Laine J, Pessi T, Aittoniemi J (2011) Plasma level of soluble urokinase-type plasminogen activator receptor as a predictor of disease severity and case fatality in patients with bacteraemia: a prospective cohort study. J Intern Med 270:32–40

    Article  CAS  PubMed  Google Scholar 

  • Kofoed K, Eugen-Olsen J, Petersen J, Larsen K, Andersen O (2008) Predicting mortality in patients with systemic inflammatory response syndrome: an evaluation of two prognostic models, two soluble receptors, and a macrophage migration inhibitory factor. Eur J Clin Microbiol Infect Dis 27:375–383

    Article  CAS  PubMed  Google Scholar 

  • Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE, Child Health Epidemiology Reference Group of WHO, UNICEF (2012) Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 379:2151–2161

    Article  PubMed  Google Scholar 

  • Madhi SA, De Wals P, Grijalva CG, Grimwood K, Grossman R, Ishiwada N, Lee PI, Nascimento-Carvalho C, Nohynek H, O’Brien KL, Vergison A, Wolter J (2013) The burden of childhood pneumonia in the developed world: a review of the literature. Pediatr Infect Dis J 32:e119–e127

    Article  PubMed  Google Scholar 

  • Ostrowski SR, Katzenstein TL, Piironen T, Gerstoft J, Pedersen BK, Ullum H (2004) Soluble urokinase receptor levels in plasma during 5 years of highly active antiretroviral therapy in HIV-1-infected patients. J Acquir Immune Defic Syndr 35:337–342

    Article  CAS  PubMed  Google Scholar 

  • Ostrowski SR, Piironen T, Hoyer-Hansen G, Gerstoft J, Pedersen BK, Akanmori BD, Kurtzhals JA (2005a) High plasma levels of intact and cleaved soluble urokinase receptor reflect immune activation and are independent predictors of mortality in HIV-1-infected patients. J Acquir Immune Defic Syndr 39:23–31

    Article  CAS  PubMed  Google Scholar 

  • Ostrowski SR, Ullum H, Goka BQ, Høyer-Hansen G, Obeng-Adjei G, Pedersen BK, Akanmori BD, Kurtzhals JA (2005b) Plasma concentrations of soluble urokinase-type plasminogen activator receptor are increased in patients with malaria and are associated with a poor clinical or a fatal outcome. J Infect Dis 191:1331–1341

    Article  CAS  PubMed  Google Scholar 

  • Plesner T, Behrendt N, Ploug M (1997) Structure, function and expression on blood and bone marrow cells of the urokinase-type plasminogen activator receptor, uPAR. Stem Cells 15:398–408

    Article  CAS  PubMed  Google Scholar 

  • Sidenius N, Sier CF, Blasi F (2000a) Shedding and cleavage of the urokinase receptor (uPAR): identification and characterisation of uPAR fragments in vitro and in vivo. FEBS Lett 475:52–56

    Article  CAS  PubMed  Google Scholar 

  • Sidenius N, Sier CF, Ullum H, Pedersen BK, Lepri AC, Blasi F, Eugen-Olsen J (2000b) Serum level of soluble urokinase-type plasminogen activator receptor is a strong and independent predictor of survival in human immunodeficiency virus infection. Blood 96:4091–4095

    CAS  PubMed  Google Scholar 

  • Sier CF, Stephens R, Bizik J, Mariani A, Bassan M, Pedersen N, Frigerio L, Ferrari A, Danø K, Brünner N, Blasi F (1998) The level of urokinase-type plasminogen activator receptor is increased in serum of ovarian cancer patients. Cancer Res 58:1843–1849

    CAS  PubMed  Google Scholar 

  • Stephens RW, Nielsen HJ, Christensen IJ, Thorlacius-Ussing O, Sørensen S, Danø K, Brünner N (1999) Plasma urokinase receptor levels in patients with colorectal cancer: relationship to prognosis. J Natl Cancer Inst 91:869–874

    Article  CAS  PubMed  Google Scholar 

  • Toldi G, Bekő G, Kádár G, Mácsai E, Kovács L, Vásárhelyi B, Balog A (2013) Soluble urokinase plasminogen activator receptor (suPAR) in the assessment of inflammatory activity of rheumatoid arthritis patients in remission. Clin Chem Lab Med 51:327–332

    Article  CAS  PubMed  Google Scholar 

  • Wiersinga WJ, Kaqer LM, Hovius JW, ven der Windt GJ, de Vos AF, Meijers JC, Roelofs JJ, Dondorp A, Levi M, Day NP, Peacock SJ, van der Poll T (2010) Urokinase receptor is necessary for bacterial defense against pneumonia-derived septic melioidosis by facilitating phagocytosis. J Immunol 184:3079–3086

    Article  CAS  PubMed  Google Scholar 

  • Wittenhagen P, Andersen JB, Hansen A, Lindholm L, Ronne F, Theil J, Tvede M, Eugen-Olsen J (2011) Plasma soluble urokinase plasminogen activator receptor in children with urinary tract infection. Biomark Insights 6:79–82

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Wrotek A, Pawlik K, Jackowska T (2013) Soluble receptor for urokinase plasminogen activator in community-acquired pneumonia in children. Adv Exp Med Biol 788:329–334

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Supported by the Medical Center of Postgraduate Education in Warsaw grant no. 502-1-20-01-12.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. Jackowska .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Wrotek, A., Jackowska, T., Pawlik, K. (2014). Soluble Urokinase Plasminogen Activator Receptor: An Indicator of Pneumonia Severity in Children. In: Pokorski, M. (eds) Respiratory Infections. Advances in Experimental Medicine and Biology(), vol 835. Springer, Cham. https://doi.org/10.1007/5584_2014_40

Download citation

Publish with us

Policies and ethics