“I was able to gain a deeper and more holistic understanding of the research process than I had in the past by participating in aspects of the project that were new to me, such as data analysis and statistics.”
Markers of lung injury in childhood pneumonia in low-resource settings
Pneumonia is the leading infectious cause of death in children worldwide, accounting for 14 per cent of all deaths of children under five years old. Diagnosing pneumonia accurately typically involves expensive tests, such as microbiology or X-ray, which can help indicate which patients need antibiotics or closer follow-up. However, in low-resource settings where the burden of childhood pneumonia is highest, these tests are often not available. An alternative is to measure proteins (or biomarkers) in the blood that indicate the body's response to infection. These have the potential to be measured by low-cost bedside tests.
In this study, we will investigate three proteins involved in the body's defence against pneumonia: chitinase-3-like protein 1 (CHI3L1), tissue inhibitor of metalloproteinases-1 (TIMP-1) and surfactant protein D (SP-D). We hypothesize that these biomarkers, which are associated with lung injury, inflammation and repair, will be clinically informative in childhood pneumonia.
We will measure blood levels of CHI3L1, TIMP-1 and SP-D in children hospitalized for pneumonia in Uganda and determine their ability to predict chest X-ray findings of pneumonia. We will also determine their association with symptoms and outcomes such as recovery times and survival. Clinical data and blood samples from 130 children at two hospitals in Uganda have already been collected and are available for analysis in our Edmonton lab. Protein levels in the blood will be measured and compared with X-ray findings and clinical outcomes.
Identifying clinically-relevant biomarkers could lead to the development of a low-cost finger-prick blood test to measure these proteins, which could be used to diagnose pneumonia or predict worse outcomes. This could be an alternative to microbiology and X-ray in low-resource areas and could help ensure that antibiotics are used appropriately and that advanced care is prioritized for the sickest children. Because of the severe impacts of childhood pneumonia in low-resource settings, this would greatly benefit child health.
Emily Konrad was supervised by Michael Hawkes and her summer studentship was funded by the Stollery Children’s Hospital Foundation. She is enrolled in the Doctor of Medicine program.