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Abstract

Objective: Ezrin, also known as villin-2 or cytovillin, is a cytoplasmic peripheral membrane protein encoded in humans with the potential implications for various human cancers, cytokine modulation, cytoskeleton remodeling, mucous membrane integrity, and epithelial or pulmonary damage. This study hypothesizes that the amounts of exosome-associated ezrin in the serum detected by ELISA may correlate with the diagnosis or severity of pneumonia in children. We aimed to examine ezrin levels as a pulmonary epithelial cell damage or inflammation marker in a clinical model of pediatric pneumonia. Methods: The prospective study was conducted with 108 previously diagnosed children with pneumonia and 59 controls. Levels of ezrin were measured in the serum by ELISA. The ROC curve was used to compare the diagnostic ability of ezrin, and further subgroup analysis was carried out in the pneumonia group. Results: Exosome-associated ezrin levels detected by ELISA in the serum of the pneumonia group of children (n=108) on the 1st day of the study were on average 2.3 ng/mL (range 0 to 30 ng/mL), significantly lower (P = 0.039) than the healthy control group of children (n=59) on the 1st day of the study, who had on average serum concentration of 3.6 ng/mL (range 0.42 to 30 ng/mL). Also, the AUC for ezrin level on the 1st day showed applicable sensitivity and specificity (ROC area = 0.59, CI: 0.51-0.67, p = 0.031). Discussion: This investigation in children with pneumonia for the first time demonstrates a significant reduction in the exosome-associated serum levels of ezrin when compared with healthy control children. Ezrin might be a promising biomarker of childhood pneumonia or disease severity associated with pneumonia-associated inflammation and epithelial damage.

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