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Plasma immunoreactive endothelin-1 concentrations in infants with persistent pulmonary hypertension of the newborn
P Kumar1, N J Kazzi, S Shankaran
1Department of Pediatrics, Children's Hospital of Michigan, Detroit, USA.
Insights
Infants with persistent pulmonary hypertension of the newborn (PPHN) show elevated plasma endothelin-1 (ET-1) levels. These higher ET-1 concentrations correlate with disease severity, suggesting ET-1 as a potential biomarker for PPHN.
Area of Science:
- Neonatal Medicine
- Cardiovascular Research
- Pediatric Pulmonology
Background:
- Plasma endothelin-1 (ET-1) is elevated in pediatric and adult pulmonary hypertension.
- Persistent pulmonary hypertension of the newborn (PPHN) is a critical neonatal condition.
- The role of ET-1 in PPHN pathophysiology requires further investigation.
Purpose of the Study:
- To investigate plasma endothelin-1 (ET-1) concentrations in infants diagnosed with persistent pulmonary hypertension of the newborn (PPHN).
- To determine if ET-1 levels correlate with the severity of PPHN in neonates.
Main Methods:
- Radioimmunoassay was used to measure plasma immunoreactive-endothelin-1 (ir-ET-1) levels.
- Study included 20 infants with PPHN and 20 healthy term infants.
- Linear regression analysis assessed correlations between ir-ET-1 and clinical parameters.
Main Results:
- Infants with PPHN had significantly higher mean plasma ir-ET-1 concentrations compared to controls (2.04 pg/mL vs 1.04 pg/mL, p=0.02).
- Elevated ir-ET-1 correlated with alveolar-arterial oxygen gradient (r=0.49, p=0.02) and mean airway pressure (r=0.49, p=0.02).
- A correlation was observed between ir-ET-1 levels and the duration of extracorporeal membrane oxygenation (r=0.44, p=0.05).
Conclusions:
- Plasma ir-ET-1 concentrations are elevated in neonates with PPHN.
- Elevated ir-ET-1 and its correlation with disease severity suggest ET-1 may be a marker for PPHN severity.
- Further research is necessary to fully understand ET-1's role in PPHN pathophysiology.
Abstract:
Plasma concentrations of endothelin-1 (ET-1) have been reported to be elevated in children and adults with pulmonary hypertension. We hypothesized that infants with persistent pulmonary hypertension of the newborn (PPHN) have elevated plasma concentrations of ET-1. Plasma concentrations of immunoreactive-endothelin-1 (ir-ET-1) were measured using a radioimmunoassay in 20 infants with PPHN and 20 normal term infants. Mean birthweight and gestational age of the infants were comparable in the two groups. The mean plasma ir-ET-1 concentrations were significantly elevated in neonates with PPHN compared to those of normal term infants (2.04 +/- 0.30 versus 1.04 +/- 0.29 pg/mL, p = 0.02). A linear regression analysis demonstrated a significant relationship between ir-ET-1 concentrations and alveolar-arterial oxygen gradient (r = 0.49, p = 0.02) and mean airway pressure (r = 0.49, p = 0.02). There was also a significant correlation between ir-ET-1 concentrations and duration of extracorporeal membrane oxygenation among infants with PPHN (r = 0.44, p = 0.05). We conclude that plasma ir-ET-1 concentrations are elevated in infants with PPHN. The presence of elevated ir-ET-1 concentrations and their positive correlation with disease severity suggests that ET-1 may serve as a marker of the disease severity in these infants. However, further studies are needed to elucidate the role of ET-1 in the pathophysiology of PPHN.