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Mediators of Inflammation
Volume 2012, Article ID 143428, 7 pages
Research Article

Circulating Cytokines and Growth Factors in Pediatric Pulmonary Hypertension

1Section of Pediatric Pulmonology, School of Medicine, University of Colorado and Children’s Hospital Colorado, Aurora, CO 80045, USA
2Obesity Research Center, King Saud University, Riyadh, Saudi Arabia
3Biodesix Inc., Boulder, CO 80045, USA
4Division of Endocrinology, Metabolism and Diabetes, School of Medicine, University of Colorado Denver, MS 8106, 12801 E. 17th Avenue, RC 1 South, Room 7103, Aurora, CO 80045, USA
5Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA
6Section of Pediatric Cardiology, School of Medicine, University of Colorado and Children’s Hospital Colorado, Aurora, Colorado 80045, USA

Received 23 June 2012; Revised 25 October 2012; Accepted 15 November 2012

Academic Editor: Dirk Holzinger

Copyright © 2012 Mark Duncan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Management of pediatric pulmonary hypertension (PH) remains challenging. We have assessed a panel of circulating proteins in children with PH to investigate their value as predictive and/or prognostic biomarkers. From these determinations, we aim to develop a practical, noninvasive tool to aid in the management of pediatric PH. Methods. Twelve cytokines and growth factors putatively associated with lung or vascular disease were examined in plasma specimens from 70 children with PH using multiplex protein array technology. Associations between hemodynamics, adverse events, and protein markers were evaluated. Results. Epidermal growth factor (EGF) and IL-6 were associated with important hemodynamics. Of the twelve proteins, VEGF and IL-6 were significantly, univariately associated with the occurrence of an adverse event, with odds ratios (95% confidence intervals) of 0.56 (0.33–0.98) and 1.69 (1.03–2.77), respectively. When hemodynamic predictors were combined with protein markers, the ability to predict adverse outcomes within the following year significantly increased. Conclusions. Specific circulating proteins are associated with hemodynamic variables in pediatric PH. If confirmed in additional cohorts, measurement of these proteins could aid patient care and design of clinical trials by identifying patients at risk for adverse events. These findings also further support a role for inflammation in pediatric PH.