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Early clinical markers for the development of bronchopulmonary dysplasia: soluble E-Selectin and ICAM-1
P L Ramsay1, E O'Brian Smith, S Hegemier
1Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Insights
Higher levels of soluble E-Selectin in the first week of life are linked to the development of bronchopulmonary dysplasia (BPD) in premature infants. These findings suggest E-selectin plays a role in lung inflammation in neonates.
Area of Science:
- Neonatal Medicine
- Pulmonology
- Immunology
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
- The pathogenesis of BPD involves inflammation and endothelial cell activation.
Purpose of the Study:
- To investigate the association between early serum concentrations of soluble adhesion molecules and the development of BPD in infants born at or before 29 weeks' gestation.
- To determine if specific adhesion molecules predict BPD severity.
Main Methods:
- Serum concentrations of soluble P-Selectin, E-Selectin, and intercellular adhesion molecule-1 were measured in cord blood and on days 1, 3, and 7 of life.
- Infants were assessed for BPD diagnosis and severity at 1 month of age.
- Duration of oxygen therapy and hospital stay were recorded.
Main Results:
- Soluble E-Selectin levels were higher in infants who developed BPD compared to those who did not, particularly in cord blood and on days 1 and 3.
- Elevated soluble E-Selectin in cord blood and on day 1 correlated with stage 3 or 4 BPD.
- Soluble intercellular adhesion molecule-1 concentrations were higher on days 3 and 7 in infants who developed BPD.
Conclusions:
- Early elevated concentrations of soluble E-Selectin are associated with BPD development and severity.
- E-selectin may play a critical role in the inflammatory processes leading to BPD.
- Prenatal or early perinatal inflammatory events likely contribute significantly to BPD pathogenesis.
Objective:
To test the hypothesis that in infants born at
Design And Methods:
In cord blood and on days of life 1, 3, and 7, we measured serum concentrations of soluble P-Selectin, E-Selectin, and intercellular adhesion molecule-1 in samples obtained from infants
Results:
Concentrations of soluble P-Selectin were greatest in cord blood samples obtained from all infants and were markedly reduced on day of life 1, regardless of the subsequent development of BPD. In serum samples obtained from cord blood and on days of life 1 and 3, soluble E-Selectin levels were higher in infants that developed BPD than in infants that did not develop BPD. In addition, the highest concentrations of soluble E-Selectin in serum samples from cord blood and on day of life 1 were associated with the development of stage 3 or 4 BPD. Soluble intercellular adhesion molecule-1 concentrations were higher on days of life 3 and 7 in the infants that went on to develop BPD than in those that did not.
Conclusions:
Because neutrophil attachment to endothelial cell adhesion molecules is a key event in the initiation of an inflammatory response, the association of higher early concentrations of soluble E-Selectin with the development of BPD suggests that E-Selectin may play a key role in the pathogenesis of lung inflammation and the development of BPD. This association also suggests that inflammatory events or effects leading to inflammatory responses occurring in the prenatal and/or very early perinatal periods contribute significantly to the pathogenesis of BPD.