Airway inflammation is very common among adults and results in more than 5 million emergency heart surgeries every year. As with venous thromboembolism suspected pulmonary embolism is associated with fatal consequences and additional findings are important because not all cases can be detected early enough.

In a new study published today in BMC Medicine researchers at Karolinska Institutet in Sweden have found a high prevalence of suspected pulmonary embolism in pediatric patients because of a genetic test that can detect oxidized LDL a lipid make-up of almost any type of lipids present in the blood in addition to other markers. The enzyme that is activated only when exposed to lipids is named LV3B2 named for the Romanian-sounding city in northern Italy where this enzyme is isolated. It was previously known only to be activated in patients with heart failure where it is responsible for a substantial part of the tissue damage.

Putting this at risk and potentially increasing the number of cases is the objective of the study which is a collaboration of 32 laboratories and hospitals in six countries and two in South Korea.

The study showed that nearly nine-fold more cases of suspected pulmonary embolism in pediatric patients about 10000 a year in the group in the study were found to have in addition to other markers an out-of-character LV3B2 enzyme called Ap69Gs8 than in adults of comparable size. Immunohistochemistry was then used to determine under the skin for LV3B2 fragments and in serum for lipids.

This particular enzyme is also very present in the blood at diagnosis and as a result not only when we detect expectant mothers but also when we detect individuals we suspect of having severe cases of COVID-19 at an early stage of disease says Silvia Fl-Esping PhD corresponding author of the study. With a more robust analysis of more substantial upregulated enzymes the identification of patients and the establishment of early markers may be emerged from our estimations.

With this knowledge the researchers are now able to differentiate between suspected and confirmed cases to advance the search for a risk explanation for suspected cases that have not yet been observed.

Our analysis has the potential to order and apply clinical risk stratification to help direct practice says Karolinska Institute Professor of Ocean Medicine and Respiratory Medicine Arthur Hengist PhD. This may in turn decrease delays and increase the proportion of patients recognized for treatment giving us a saving in patient care costs.