PRTN3/FCER1A Transcriptomic Ratio Predicts Hospitalization in Primary Care Attenders With Respiratory Infection

Abstract Early detection of patients with respiratory infection at risk of deteriorating could help to improve their outcome by facilitating immediate transfer to the hospital to receive the adequate level of care. In this regard, gene expression profiling is emerging as a promising tool to identify patients with infection at risk of suffering a complicated outcome. In a cohort of patients with respiratory infection attending to an Emergency Room at a community health centre, we quantified expression levels in blood of five genes involved in the granulocyte biology that have been previously described to be linked to infection severity: MMP8 (matrix metallopeptidase 8), LCN2 (lipocalin-2), LTF (lactotransferrin) and PRTN3 (proteinase 3) and FCER1A (receptor for Fc fragment of IgE, high affinity I). Expression levels of these genes were evaluated to predict hospitalization. Multivariate analysis adjusted by the National Early Warning Score (NEWS), neurovascular disease, hypertension and age revealed that all these genes independently predicted hospitalization. Nonetheless, the ratio between PRTN3/FCER1A outperformed individual genes to predict necessity of hospitalization (OR [CI95%], p: 8.36 [2.02-34.52],0.003). In conclusion, quantification of PRTN3/FCER1A gene expression ratio could represent a useful test to early identify those patients with respiratory infection at risk of deterioration in extra-hospital settings.