Combination of serum AIM2 and caspase-5 as a predictor of unfavorable prognosis in children with lobar pneumonia: a prospective cohort study.
- 1Respiratory Department II, Hebei Children's Hospital, Shijiazhuang, Hebei, China.
- 2Respiratory Department III, Hebei Children's Hospital, Shijiazhuang, Hebei, China.
- 3Department of Pediatrics Ward 1, Shexian Hospital, Handan, China.
Abstract
To validate whether serum levels of absent in melanoma 2 (AIM2) and caspase-5 can serve as early combined biomarkers of unfavorable prognosis in children with lobar pneumonia. From February 2022 to June 2025, 475 children aged 1-14 years with first-episode lobar pneumonia were prospectively enrolled at Hebei Children's Hospital. Patients were divided into a favorable-prognosis group (n = 395) and an unfavorable-prognosis group (n = 80) based on treatment outcomes assessed during outpatient follow-up visits conducted 4-6 weeks after discharge. Fasting venous blood was drawn within 24 h of admission, and levels of AIM2 and caspase-5 were measured by enzyme-linked immunosorbent assay (ELISA). Co-infection, symptom duration, antibiotic duration, hospital stay, C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH) were recorded. Prognostic associations were examined using Pearson correlation, multivariable logistic regression, and receiver operating characteristic (ROC) analysis. Multicollinearity was assessed; a tolerance > 0.1 and a variance inflation factor (VIF) < 10 were considered acceptable. Serum AIM2 and caspase-5 levels were significantly higher in the unfavorable-prognosis group than in the favorable-prognosis group (both P < 0.001), and the two markers were positively correlated (r = 0.241, P < 0.001). Multivariable analysis identified co-infection and elevated levels of CRP, PCT, AIM2, and caspase-5 as independent risk factors for unfavorable prognosis. The VIF ranged from 1.047 to 1.131, indicating no multicollinearity. The combination of AIM2 and caspase-5 yielded an AUC of 0.839 (95% CI 0.798-0.879) for predicting unfavorable prognosis, with a sensitivity of 75.70% and a specificity of 78.75%, which was significantly superior to either biomarker alone (DeLong test: Z = -4.248, P < 0.001; Z = -2.998, P = 0.003). Nested model analysis demonstrated that adding AIM2 and caspase-5 to conventional variables (co-infection, CRP, PCT, and LDH) improved the AUC from 0.855 to 0.893 (DeLong test P = 0.047), indicating significant incremental predictive value. Elevated serum AIM2 and caspase-5 are independent risk factors for unfavorable prognosis in children with lobar pneumonia. Their combination shows favorable predictive performance and may help identify high-risk children early.
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BibTeX
@article{liu2026combination,
title = {{Combination of serum AIM2 and caspase-5 as a predictor of unfavorable prognosis in children with lobar pneumonia: a prospective cohort study.}},
author = {Linlin Liu and Xiaoxue Qi and Liping Zhang and Jianfang Jiang and Wenshan Lyu and Yuxiao Hu and Peiqing Huo},
journal = {Frontiers in pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1907114},
url = {https://europepmc.org/article/MED/42952765},
note = {CC BY},
}
RIS
TY - JOUR
TI - Combination of serum AIM2 and caspase-5 as a predictor of unfavorable prognosis in children with lobar pneumonia: a prospective cohort study.
AU - Linlin Liu
AU - Xiaoxue Qi
AU - Liping Zhang
AU - Jianfang Jiang
AU - Wenshan Lyu
AU - Yuxiao Hu
AU - Peiqing Huo
PY - 2026
DA - 2026/10/14
JO - Frontiers in pediatrics
DO - 10.3389/fped.2026.1907114
UR - https://europepmc.org/article/MED/42952765
AB - To validate whether serum levels of absent in melanoma 2 (AIM2) and caspase-5 can serve as early combined biomarkers of unfavorable prognosis in children with lobar pneumonia. From February 2022 to June 2025, 475 children aged 1-14 years with first-episode lobar pneumonia were prospectively enrolled at Hebei Children's Hospital. Patients were divided into a favorable-prognosis group (n = 395) and an unfavorable-prognosis group (n = 80) based on treatment outcomes assessed during outpatient follow-up visits conducted 4-6 weeks after discharge. Fasting venous blood was drawn within 24 h of admission, and levels of AIM2 and caspase-5 were measured by enzyme-linked immunosorbent assay (ELISA). Co-infection, symptom duration, antibiotic duration, hospital stay, C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH) were recorded. Prognostic associations were examined using Pearson correlation, multivariable logistic regression, and receiver operating characteristic (ROC) analysis. Multicollinearity was assessed; a tolerance > 0.1 and a variance inflation factor (VIF) < 10 were considered acceptable. Serum AIM2 and caspase-5 levels were significantly higher in the unfavorable-prognosis group than in the favorable-prognosis group (both P < 0.001), and the two markers were positively correlated (r = 0.241, P < 0.001). Multivariable analysis identified co-infection and elevated levels of CRP, PCT, AIM2, and caspase-5 as independent risk factors for unfavorable prognosis. The VIF ranged from 1.047 to 1.131, indicating no multicollinearity. The combination of AIM2 and caspase-5 yielded an AUC of 0.839 (95% CI 0.798-0.879) for predicting unfavorable prognosis, with a sensitivity of 75.70% and a specificity of 78.75%, which was significantly superior to either biomarker alone (DeLong test: Z = -4.248, P < 0.001; Z = -2.998, P = 0.003). Nested model analysis demonstrated that adding AIM2 and caspase-5 to conventional variables (co-infection, CRP, PCT, and LDH) improved the AUC from 0.855 to 0.893 (DeLong test P = 0.047), indicating significant incremental predictive value. Elevated serum AIM2 and caspase-5 are independent risk factors for unfavorable prognosis in children with lobar pneumonia. Their combination shows favorable predictive performance and may help identify high-risk children early.
SN - 2296-2360
ER -