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Plasma Proendothelin-1 as an Early Marker of Bronchopulmonary Dysplasia
Philipp Baumann1, Sotirios Fouzas, Isabelle Pramana
1Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Insights
Plasma proendothelin-1 (CT-proET-1) shows promise in predicting bronchopulmonary dysplasia (BPD) in preterm infants. Measuring CT-proET-1 by the end of the first week of life offers excellent predictive ability for BPD development.
Area of Science:
- Neonatal Medicine
- Pulmonology
- Biomarker Research
Background:
- Bronchopulmonary dysplasia (BPD) is a frequent complication in preterm infants, posing challenges for early clinical prediction.
- Plasma proendothelin-1 (CT-proET-1), a known lung injury biomarker, is investigated for its prognostic role in BPD.
Purpose of the Study:
- To evaluate the prognostic capability of CT-proET-1 for predicting BPD in preterm infants.
- To determine the optimal timing for CT-proET-1 measurement for BPD prediction.
Main Methods:
- A prospective study enrolled 227 preterm infants (<32 weeks gestational age).
- Plasma CT-proET-1 levels were measured at multiple time points: birth, days of life (DOL) 2, 3, 6, 28, and 36 weeks postmenstrual age (PMA).
- BPD was classified as mild (oxygen at DOL 28) or moderate/severe (oxygen at 36 weeks PMA).
Main Results:
- CT-proET-1 demonstrated poor predictive ability at birth (AUC 0.654), moderate at DOL 2-3 (AUC 0.769), and excellent at DOL 6 (AUC 0.918).
- Multivariable analysis confirmed CT-proET-1 levels at DOL 2, 3, 6, and 28 were significantly associated with oxygen supplementation duration, independent of gestational age and respiratory support duration.
Conclusions:
- CT-proET-1 emerges as a promising novel biomarker for predicting BPD in preterm infants.
- Measurement of CT-proET-1 towards the end of the first week of life (DOL 6) provides excellent prognostic accuracy for BPD development.
Background:
Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants. Clinical prediction of BPD at an early stage in life is difficult. Plasma proendothelin-1 (CT-proET-1) is a lung injury biomarker in pulmonary hypertension and respiratory distress.
Objective:
To assess the prognostic ability of CT-proET-1 in BPD.
Methods:
In 227 prospectively enrolled preterm infants born at <32 weeks gestational age (GA), plasma CT-proET-1 was measured at birth, day of life (DOL) 2, 3, 6 and 28, and at 36 weeks postmenstrual age (PMA). BPD was defined as mild in infants requiring supplemental oxygen at DOL 28 and moderate/severe in those requiring it at 36 weeks PMA.
Results:
The predictive ability of CT-proET-1 for any BPD was poor at birth [area under the ROC curve (AUC) 0.654, 95% CI 0.494-0.814], moderate at DOL 2 and 3 (AUC 0.769, 95% CI 0.666-0.872) and excellent at DOL 6 (AUC 0.918, 95% CI 0.840-0.995). Multivariable regression analysis revealed that CT-proET-1 levels at DOL 2, 3, 6 and 28 were strongly related to the duration of oxygen supplementation, independently of GA and the duration of respiratory support.
Conclusions:
CT-proET-1 is a novel promising biomarker for predicting the development of BPD in preterm infants when measured at the end of the first week of life.
