# Urinary Proadrenomedullin to Improve Risk Stratification of Children with Community-Acquired Pneumonia

> **NIH NIH R03** · LURIE CHILDREN'S HOSPITAL OF CHICAGO · 2020 · $78,810

## Abstract

PROJECT SUMMARY/ABSTRACT
Although community-acquired pneumonia (CAP) is one of the most common serious bacterial infections in
children, no validated decision tools exist to gauge illness severity among children with CAP. Without objective
tools, management decisions are inefficient and potentially inaccurate, resulting in the use of unnecessary
tests, therapies and hospitalizations in low-risk children or delays in critically important therapies in those at
high risk of severe outcomes. The long-term goal of this research is to improve risk stratification of children
with lower respiratory tract infections. Proadrenomedullin (proADM) is a vasodilatory peptide that, when
measured in blood, has shown great potential to improve severity prediction in adults and children with CAP.
Obtaining blood for biomarker measurements in children has several disadvantages, including pain, anxiety,
invasiveness, and need for technical and procedural expertise. Proadrenomedullin can also be measured in
urine, offering several important advantages, including ease of collection, cost effectiveness, and lack of
discomfort. There is a paucity of data, however, on the role of urinary proADM in predicting clinical outcomes in
children with suspected CAP. The overall objective of this R03 is to perform a proof-of-principle study to
examine the ability of urinary proADM to predict clinical outcomes and disease severity in pediatric CAP. The
scientific premise of the proposed study is based on (a) strong preliminary data from the PI's K23 that plasma
proADM is associated with severe outcomes in suspected CAP in children, (b) feasibility testing finding a
normally distributed range of concentrations of proADM in urine, (c) data demonstrating that plasma and
urinary proADM levels are correlated, and (d) a body of literature suggesting that proADM is strongly
associated with severe outcomes in adults with CAP. The specific aim of this R03 is to evaluate the
association between urinary proADM levels and clinical outcomes in children with suspected CAP. The central
hypothesis is that higher levels of urinary proADM will be associated with severe clinical outcomes. The
investigators will leverage existing clinical data and urine specimens collected from 407 children at the time of
initial evaluation as part of the PI's K23, a prospective cohort study of children 3 months to 18 years of age with
suspected CAP who presented to the emergency department (ED). The proposed research is innovative in
that it represents a new and substantive departure from the status quo by shifting the paradigm from
inaccurate, subjective, or invasive risk stratification methods to an objective, accurate, rapid, and non-invasive
approach that can be applied across multiple settings. This contribution is significant because effectively
predicting disease severity in children with suspected CAP using proADM will ultimately improve the accuracy
and reliability of management decisions by stratifying child...

## Key facts

- **NIH application ID:** 9941030
- **Project number:** 5R03AI147112-02
- **Recipient organization:** LURIE CHILDREN'S HOSPITAL OF CHICAGO
- **Principal Investigator:** Todd Adam Florin
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $78,810
- **Award type:** 5
- **Project period:** 2019-06-03 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9941030

## Citation

> US National Institutes of Health, RePORTER application 9941030, Urinary Proadrenomedullin to Improve Risk Stratification of Children with Community-Acquired Pneumonia (5R03AI147112-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9941030. Licensed CC0.

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