Transforming Growth Factor β Level in Healthy Pediatric Children: Strong Impact of Age

Background: TGFβ plays a major role in the pathogenesis of aortic root dilatation in Marfan's syndrome (MFS). Inhibiting TGFβ using AT1-antagonists is effective to reduce the aortic root dilatation. Due to possible early diagnosis of disease the number of pediatric patients with aortic pathologies and thus pharmacological therapy increases whereas clinical data of TGFβ has yet hardly been investigated in children. To understand the role of TGFβ in pediatric patients, first normal values in healthy children are crucial.

Method: We measured TGFβ levels in 125 children between 2017 and 2019 (9.4 ± 5.7 years; male, 57.6% and female, 42.4%). Thereby, we included children with mild infections, minor elective surgeries, trauma, and social and behavioral problems.

Results: Our data show a general decline of TGFβ that the older the children get ([Table 1]). TGFβ is significantly lower in children with the beginning of puberty and adolescence in comparison to younger children (p = 0.001). There were no gender differences of TGFβ at any age (p > 0.05). Other collected parameters in blood were taken into consideration. There was no correlation between TGFβ level and CRP or kreatinin levels (p > 0.05). Overall the TGFβ-levels are broadly distributed.

Table 1  TGFβ in pg‎/mL

Age	n	Mean	SD	SE	95% KI		Minimum	Maximum
					Minimum	Maximum
1–24 months	22	7,326	2,394	510	6,265	8,387	3,877	15,273
25 months–11 years	43	7,578	3,609	550	6,467	8,689	3,189	16,914
12–14 years	30	5,360	1,717	313	4,718	6,001	2,157	8,883
15–18 years	30	5,560	2,024	370	4,804	6,316	1,818	12,161
Total	125	6,517	2,843	254	6,014	7,020	1,818	16,914

Conclusion: This study is so far the largest examination of TGFβ levels in children. TGFβ decreases with age, especially at the reach of puberty. Our results correlate with present studies which focused on TGFβ levels in adults mainly. In the next step, the levels can be compared with those in children with MFS to establish a possible new instrument for the indication and management of medication. As a limiting factor, the TGFβ levels are broadly distributed. Larger pediatric collectives need to be investigated for actual diagnostic use in the future.

Publication History

Article published online:
12 February 2022