A Coordinated Adhesion-Molecule Activation Profile in Pediatric Sepsis: A Prospective Cohort Study from Vietnam
- 1Department of Pediatric Intensive Care, Children’s Hospital 2, Ho Chi Minh City 700000, Vietnam
- 2Department of Pediatrics, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
- 3Dong Nai Children’s Hospital, Dong Nai City 760000, Vietnam
Abstract
Background/Objectives: Pediatric sepsis is increasingly recognized as a syndrome involving immune–vascular dysregulation. However, most pediatric biomarker studies focus on individual molecules rather than coordinated patterns of leukocyte–endothelial activation. This study aimed to evaluate whether children diagnosed with sepsis within 48 h of admission showed a coordinated soluble adhesion-molecule activation profile measured at enrollment. Methods: This prospective cohort study included 144 children aged 1–60 months with suspected infection enrolled at Dong Nai Children’s Hospital, Vietnam, from May 2021 to October 2022. Blood samples were collected at enrollment. Sepsis was classified according to the 2005 International Pediatric Sepsis Consensus Conference (IPSCC) criteria within 48 h of admission. Twelve soluble adhesion molecules were measured using a multiplex immunoassay. A composite adhesion activation score was derived by log2 transformation, z-score standardization, and averaging across the 12 markers. Principal component analysis (PCA) was used as an exploratory method to summarize the shared variation across the adhesion-molecule panel. C-reactive protein (CRP) was included as a routinely available inflammatory comparator. Results: Among 144 children, 32 (22.2%) were diagnosed with sepsis within 48 h of admission. Individual marker discrimination was strongest for L-selectin (area under the receiver operating characteristic curve [AUC] 0.883), followed by soluble vascular cell adhesion molecule-1 (sVCAM-1; AUC 0.855), intercellular adhesion molecule-3 (ICAM-3; AUC 0.838), P-selectin glycoprotein ligand-1 (PSGL-1; AUC 0.836), E-selectin (AUC 0.819), and intercellular adhesion molecule-2 (ICAM-2; AUC 0.819). CRP also differed between children with and without sepsis but had a lower AUC than the leading adhesion molecules in descriptive ROC analyses. The composite adhesion activation score was strongly associated with sepsis (odds ratio 7.95 per 1-standard deviation increase; 95% confidence interval 3.44–18.40; p < 0.001) and showed good discrimination (AUC 0.855; 95% confidence interval 0.776–0.931). The first principal component explained 70.0% of biomarker variance, consistent with coordinated elevation of correlated adhesion molecules. Conclusions: In this prospective Vietnamese pediatric cohort, children diagnosed with sepsis within 48 h of admission showed coordinated elevation of soluble adhesion molecules measured at enrollment. These findings support the biological relevance of leukocyte–endothelial activation in pediatric sepsis. However, the adhesion-molecule activation profile should be considered exploratory and hypothesis-generating, requiring external validation and further evaluation against simplified, clinically feasible biomarker approaches.
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BibTeX
@article{liem2026coordinated,
title = {{A Coordinated Adhesion-Molecule Activation Profile in Pediatric Sepsis: A Prospective Cohort Study from Vietnam}},
author = {Bui Thanh Liem and CHU VAN THIEN and Nguyen Trong Nghia and Le Anh Phong and Ngo Nhu Dinh and Nguyen Huy Luan and Phung Nguyen The Nguyen},
journal = {Pediatric Reports},
year = {2026},
month = jun,
doi = {10.3390/pediatric18030078},
url = {https://doi.org/10.3390/pediatric18030078},
note = {CC BY},
}
RIS
TY - JOUR
TI - A Coordinated Adhesion-Molecule Activation Profile in Pediatric Sepsis: A Prospective Cohort Study from Vietnam
AU - Bui Thanh Liem
AU - CHU VAN THIEN
AU - Nguyen Trong Nghia
AU - Le Anh Phong
AU - Ngo Nhu Dinh
AU - Nguyen Huy Luan
AU - Phung Nguyen The Nguyen
PY - 2026
DA - 2026/06/09
JO - Pediatric Reports
DO - 10.3390/pediatric18030078
UR - https://doi.org/10.3390/pediatric18030078
AB - Background/Objectives: Pediatric sepsis is increasingly recognized as a syndrome involving immune–vascular dysregulation. However, most pediatric biomarker studies focus on individual molecules rather than coordinated patterns of leukocyte–endothelial activation. This study aimed to evaluate whether children diagnosed with sepsis within 48 h of admission showed a coordinated soluble adhesion-molecule activation profile measured at enrollment. Methods: This prospective cohort study included 144 children aged 1–60 months with suspected infection enrolled at Dong Nai Children’s Hospital, Vietnam, from May 2021 to October 2022. Blood samples were collected at enrollment. Sepsis was classified according to the 2005 International Pediatric Sepsis Consensus Conference (IPSCC) criteria within 48 h of admission. Twelve soluble adhesion molecules were measured using a multiplex immunoassay. A composite adhesion activation score was derived by log2 transformation, z-score standardization, and averaging across the 12 markers. Principal component analysis (PCA) was used as an exploratory method to summarize the shared variation across the adhesion-molecule panel. C-reactive protein (CRP) was included as a routinely available inflammatory comparator. Results: Among 144 children, 32 (22.2%) were diagnosed with sepsis within 48 h of admission. Individual marker discrimination was strongest for L-selectin (area under the receiver operating characteristic curve [AUC] 0.883), followed by soluble vascular cell adhesion molecule-1 (sVCAM-1; AUC 0.855), intercellular adhesion molecule-3 (ICAM-3; AUC 0.838), P-selectin glycoprotein ligand-1 (PSGL-1; AUC 0.836), E-selectin (AUC 0.819), and intercellular adhesion molecule-2 (ICAM-2; AUC 0.819). CRP also differed between children with and without sepsis but had a lower AUC than the leading adhesion molecules in descriptive ROC analyses. The composite adhesion activation score was strongly associated with sepsis (odds ratio 7.95 per 1-standard deviation increase; 95% confidence interval 3.44–18.40; p < 0.001) and showed good discrimination (AUC 0.855; 95% confidence interval 0.776–0.931). The first principal component explained 70.0% of biomarker variance, consistent with coordinated elevation of correlated adhesion molecules. Conclusions: In this prospective Vietnamese pediatric cohort, children diagnosed with sepsis within 48 h of admission showed coordinated elevation of soluble adhesion molecules measured at enrollment. These findings support the biological relevance of leukocyte–endothelial activation in pediatric sepsis. However, the adhesion-molecule activation profile should be considered exploratory and hypothesis-generating, requiring external validation and further evaluation against simplified, clinically feasible biomarker approaches.
SN - 2036-749X
SN - 2036-7503
ER -