Quantitative indicators of TREC and KREC as predictors of the severity of acute respiratory infections in children

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Abstract

Introduction. TREC (T-cell Receptor Excision Circle) and KREC (Kappa-deleting Recombination Excision Circle) are markers of lymphocyte production and indirectly reflect the state of the adaptive immune system. Their concentration in dried blood spots can be determined by quantitative polymerase chain reaction (qPCR). Currently, these markers are used for neonatal screening of primary immunodeficiency conditions.

Objective: To assess TREC and KREC levels in children aged 1 to 17 years with acute respiratory infections to predict disease severity.

Material and methods. A retrospective study was conducted at Children’s City Clinical Hospital No.9 named after G.N. Speransky. The study included 180 children with acute respiratory infections (105 with community-acquired pneumonia; 75 with acute respiratory viral infections) and 90 healthy children as a control group. TREC and KREC concentrations were determined in dried venous blood spots using quantitative real-time PCR.

Results. TREC and KREC concentrations in children with acute respiratory infections were statistically significantly lower compared to the control group (p < 0.05). The discriminatory ability of TREC concentration was higher than that of KREC (TREC: AUC > 0.84 for all age groups; KREC: AUC 0.73 – 0.79). Children with the lowest TREC levels (first quartile) were hospitalized earlier from disease onset and had longer hospital stays. The lowest TREC levels were associated with higher incidence of respiratory failure and elevated C-reactive protein levels.

Conclusion. Children with acute respiratory infections show statistically significant reduction in both TREC and KREC concentrations. Low TREC levels are prognostically unfavorable factors associated with more severe disease course.

About the authors

Ekaterina V. Ligskaya

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: ligskaya_e_v@staff.sechenov.ru
ORCID iD: 0009-0006-1262-8518

Assistant, Department of Pediatrics and Pediatric Infectious Diseases, Filatov Clinical Institute of Children’s Health

Russian Federation, Trubetskaya str., 8/2, Moscow, 119991

Alina V. Eremeeva

Sechenov First Moscow State Medical University (Sechenov University)

Email: eremeeva_a_v@staff.sechenov.ru
ORCID iD: 0000-0002-2892-4665

Professor, Department of Pediatrics and Pediatric Infectious Diseases, Filatov Clinical Institute of Children’s Health

Russian Federation, Trubetskaya str., 8/2, Moscow, 119991

Dmitry A. Kudlay

Sechenov First Moscow State Medical University (Sechenov University); Institute of Immunology Federal Medical-Biological Agency; Lomonosov Moscow State University

Email: d624254@gmail.com
ORCID iD: 0000-0003-1878-4467

Doctor of Medical Sciences, Corresponding Member of the Russian Academy of Sciences, Professor, Department of Pharmacology, Institute of Pharmacy; Leading Researcher, Laboratory of Personalized Medicine and Molecular Immunology; Deputy Dean for Scientific and Technological Development, Faculty of Bioengineering and Bioinformatics, Senior Researcher, Faculty of Bioengineering and Bioinformatics

Russian Federation, Trubetskaya str., 8/2, Moscow, 119991; Kashirskoe shosse, 24, Building 2, Moscow, 115478; Leninskie Gory, 1, Moscow, 119991

Oleg V. Satyshev

Autonomous Non-Profit Organization of Additional Professional Education «Institute of Professional Education in Healthcare and Social Development»

Email: satyshev@mail.ru
ORCID iD: 0000-0002-4407-7558

Candidate of Medical Sciences, Leading Researcher

Russian Federation, Mendeleeva Street, 217/1, Ufa, 450098

Maria A. Gordukova

G.N. Speransky City Children’s Clinical Hospital No. 9

Email: GordukovaMA@zdrav.mos.ru
ORCID iD: 0000-0002-3948-8491

Candidate of Biological Sciences, Biologist, Clinical Diagnostic Laboratory

Russian Federation, Shmitovsky pr., 29, Moscow, 123317

Anatoly A. Korsunsky

Sechenov First Moscow State Medical University (Sechenov University); G.N. Speransky City Children’s Clinical Hospital No. 9

Email: korsunskiy_a_a@staff.sechenov.ru
ORCID iD: 0000-0002-9087-1656

Head of the Department of Pediatrics and Pediatric Infectious Diseases, Filatov Clinical Institute of Children’s Health

Russian Federation, Trubetskaya str., 8/2, Moscow, 119991; Shmitovsky pr., 29, Moscow, 123317

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