{
  "abstract": "Many pediatric patients with severe bacterial infection (SBI) present with a compromised general clinical picture. Early identification of the infectious and inflammatory state can improve clinical outcomes. Although microbiological culture remains the gold standard for diagnosis, its delayed results highlight the need for early biomarkers to improve clinical decision-making and patient outcomes. During infection, the acute phase response alters lipid metabolism, compromising cholesterol efflux. In this study, we characterized the serum lipid profile and HDL subclasses in 63 children with SBI at hospital admission (T0) and discharge (T1), comparing them with 63 age- and sex-matched healthy subjects. At T0, we found a significant reduction in serum total cholesterol, LDL cholesterol, and HDL cholesterol in subjects with SBI compared to controls. Interestingly, at a cut-off value of 41.5 mg/dL, HDL cholesterol discriminated the two groups with a sensitivity of 76% and a specificity of 86% for SBI. At T1, total and LDL cholesterol increased, while HDL cholesterol remained unchanged. Moreover, we observed at T1 a clear remodeling of HDL classes, with a significant decrease in large HDL with pro-inflammatory activity and an increase in the intermediate and small HDL with anti-inflammatory activity, compared to time T0. This study proposes serum HDL cholesterol as a candidate biomarker and highlights the role of HDL cholesterol and its classes in inflammatory and immune regulation in systemic bacterial infection, potentially identifying patients who could benefit from HDL-based therapies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy",
    "CEINGE-Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy",
    "Chronic Diseases, Hepatology and Nutrition Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy",
    "Clinical Pathology Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy",
    "General Pediatrics and Immuno-Rheumatology Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy",
    "Neonatal Intensive Care and Neonatology Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy",
    "Pediatric Pulmonology and Respiratory Sub-Intensive Care Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy",
    "Pediatric Intensive Care Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy",
    "Epidemiology, Biostatistics and Childhood Cancer Registry Unit, AORN Santobono-Pausilipon IRCCS, 80122 Naples, Italy",
    "Chronic and Multifactorial Diseases Unit, AORN Santobono-Pausilipon IRCCS, 80129 Naples, Italy"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Arianna Finizio",
      "orcid": "0009-0007-7080-0846"
    },
    {
      "affs": [
        2
      ],
      "name": "Marco Sarno",
      "orcid": "0000-0002-1679-4437"
    },
    {
      "affs": [
        3
      ],
      "name": "Chiara Botti",
      "orcid": "0000-0002-2304-5303"
    },
    {
      "affs": [
        1
      ],
      "name": "Alice Castaldo"
    },
    {
      "affs": [
        4
      ],
      "name": "Andrea Catzola"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Gustavo Cernera",
      "orcid": "0000-0002-1370-9786"
    },
    {
      "affs": [
        2
      ],
      "name": "Gilda Crispino"
    },
    {
      "affs": [
        4
      ],
      "name": "Giovanna Di Nardo"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Monica Gelzo",
      "orcid": "0000-0002-1500-0746"
    },
    {
      "affs": [
        5
      ],
      "name": "Lorenza Lepore"
    },
    {
      "affs": [
        2
      ],
      "name": "Claudia Mandato"
    },
    {
      "affs": [
        6
      ],
      "name": "Virginia Mirra",
      "orcid": "0009-0004-3256-9047"
    },
    {
      "affs": [
        7
      ],
      "name": "Silvia Moggia",
      "orcid": "0009-0002-5993-5006"
    },
    {
      "affs": [
        4
      ],
      "name": "Francesco Nunziata",
      "orcid": "0000-0002-7351-4104"
    },
    {
      "affs": [
        4
      ],
      "name": "Francesca Orlando",
      "orcid": "0000-0001-9121-7536"
    },
    {
      "affs": [
        2
      ],
      "name": "Antonia Pascarella",
      "orcid": "0000-0002-6997-8950"
    },
    {
      "affs": [
        5
      ],
      "name": "Luca Pierri",
      "orcid": "0000-0002-6096-7497"
    },
    {
      "affs": [
        2
      ],
      "name": "Margherita Rosa",
      "orcid": "0000-0003-3767-2807"
    },
    {
      "affs": [
        8
      ],
      "name": "Fabio Savoia",
      "orcid": "0000-0001-7132-0050"
    },
    {
      "affs": [
        9
      ],
      "name": "Paolo Siani"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Giuseppe Castaldo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9htdzm939rnj7.bib",
  "cited_by": 0,
  "doi": "10.3390/ijms27209300",
  "fulltext_url": "https://europepmc.org/articles/PMC13704984",
  "id": "9htdzm939rnj7",
  "issns": [
    "1422-0067"
  ],
  "landing_url": "https://www.mdpi.com/1422-0067/27/20/9300",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Cholesterol and Lipid Metabolism"
    ]
  ],
  "openalex": "W7223029417",
  "pdf_url": "https://europepmc.org/articles/PMC13704984?pdf=render",
  "pmcid": "PMC13704984",
  "pmid": "42942070",
  "published": "2026-10-20",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/9htdzm939rnj7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:57Z",
      "native_id": "10.3390/ijms27209300",
      "source": "crossref",
      "url": "https://www.mdpi.com/1422-0067/27/20/9300"
    },
    {
      "first_seen": "2026-10-30T12:22:12Z",
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      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42942070"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Cholesterol and Lipid Metabolism",
      "subfield": "surgery"
    }
  ],
  "title": "HDL Remodeling in Severe Bacterial Infection in Children: A Potential Biomarker for Diagnosis and Therapeutic Monitoring",
  "title_text": "HDL Remodeling in Severe Bacterial Infection in Children: A Potential Biomarker for Diagnosis and Therapeutic Monitoring",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:12Z",
  "url": "https://research.draconitic.com/paper/9htdzm939rnj7",
  "venue": "International Journal of Molecular Sciences",
  "versions": []
}