Hexosaminidase: A biochemical marker for necrotizlng enterocolitls in the preterm infant (original) (raw)
Related papers
2015
Necrotizing enterocolitis (NEC) is an inflammatory disease of the intestine primarily affecting preterm infants. Currently, the diagnosis of NEC is based on a constellation of non-specific clinical symptoms and signs, radiologic findings, and laboratory data (Bell's staging criteria). However, a definitive diagnosis of NEC is difficult because of its similarity in presentation to other clinical conditions. Biomarkers measured in stool samples will better reflect inflammation and pathology specific to the intestine. Certain stool markers are able to identify inflammatory bowel disease in pediatric and …
Biomarkers for Infants at Risk for Necrotizing Enterocolitis: Clues to Prevention?
Pediatric Research, 2009
Necrotizing enterocolitis (NEC) is the most common severe gastrointestinal emergency that affects premature newborns. This disease often has a rapid onset with few, if any, antecedent signs that can be used to reliably predict its occurrence. Its rapid onset and progression to death, as well as its severe morbidity when the infant survives, begs for early diagnostic tools that may be used in determining those infants who would be at greatest risk for development of the disease and for whom early preventative measures could be targeted. Although studies have suggested efficacy of several techniques such as breath hydrogen, inflammatory mediators in blood, urine or stool, and genetic markers, these all have drawbacks limiting their use. The application of newly developed "omic" approaches may provide biomarkers for early diagnosis and targeted prevention of this disease.
The Role of Oxidative Stress in the Necrotizing Enterocolitis of Preterm
Journal of the Siena Academy of Sciences, 2012
Introduction: Oxidative stress (OS) is strongly envolved in the pathogenesis of many preterm newborn diseases; this is due to the low efficiency of natural antioxidant systems unable to counteract the harmful effects of free radicals (FRs). Necrotizing Enterocolitis (NEC) is a multifactorial disease and it is part of the so called "free radicals related diseases". Hypoxic-ischaemic events and inflammation, involved in NEC pathogenesis, are responsible of the overproduction of free radicals (FRs), generating OS. Aim: To test the hypotesis that OS marker levels in cord blood may predict the onset of NEC in high risk infants. Materials and methods: 91 preterm newborns of gestational age between 24 and 33 weeks and birth weight between 460 and 2540 grams were consecutively recruited in two italian neonatal intensive care units. Markers of potential oxidative stress risk, Non Protein Bound Iron (NPBI), and free radicals damage, Advanced Oxidation Protein Products (AOPP) and Total Hydroperoxide (TH), were measured in the cord blood. Associations between NEC and OS markers have been checked through inferential analysis (univariate logistic regression). Results: Out of 91 preterm babies, 8 developed NEC. Babies with NEC had a birth weight (BW) and a gestational age (GA) significantly lower than healthy babies (BW=1100,52 ± 444,30 vs 1320,53 ± 462,09; GA=29,02 ± 2,09 vs 30,14 ± 2,33, respectively. p<0.005). Cord blood levels of TH and NPBI were higher in babies with NEC than in babies without, but not significantly. AOPP cord blood levels were significantly higher in babies with NEC than the babies without (AOPP=29,15 ± 20,02 vs 16,72 ± 7,34; p<0.05). AOPP demonstrated a significant value for the identification of the risk of NEC (OR=1.13, CI 95%= 1.001-1.282). Conclusions: OS is strongly associated with NEC. The determination of biochemical OS markers in cord blood can be useful in identifying babies at high risk to develop NEC and in devising new strategies to bring consistent benefits to premature babies.
European Journal of Pediatrics, 2019
We aimed to investigate the role of hypoxia-ischemia in the pathophysiology of early NEC/NEC like disease (ENEC) and classic NEC/NEC like disease (CNEC) in preterm infants. In this pilot study, preterm infants who developed the clinical symptoms and signs of NEC/NEC like disease were divided into two groups as early (≤ 7 days, ENEC) or late (> 7 days, CNEC) groups. Beside clinical variables, serum L-lactate, endothelin-1 (ET-1), platelet activating factor (PAF), and intestinal fatty acid binding protein (I-FABP) levels were measured from umbilical/peripheric venous blood in the first hour of life and during the clinical presentation in all groups. A total of 86 preterm infants were enrolled in the study. In the ENEC group, the incidences of fetal umbilical artery Doppler velocimetry abnormalities, IUGR, and delayed passage of first meconium were higher. In addition, mean levels of L-lactate, ET-1, PAF, and I-FABP were higher in the first hour of life. Conclusion: Our study firstly showed that the dominant pathophysiological factor of ENEC is prenatal hypoxic-ischemic event where intestinal injury and inflammation begin in-utero and become clinically apparent in the first week of life. Therefore, we propose a new term "Hypoxic-Ischemic Enterocolitis (HIEnt)" for the definition of ENEC in preterm infants with prenatal hemodynamic disturbances and IUGR. This new sight can provide individualized preventive and therapeutic strategies for preterm infants. What is Known: • The pathophysiology of early necrotizing enterocolitis (NEC) or NEC-like disease which is seen in the first week of life seems different than classic necrotizing enterocolitis (CNEC) which is always seen after the first week of life. What is New: • This study suggests that perinatal hypoxic-ischemic process with inflammation is the point of origin of fetal intestinal injury leading to ENEC. • We propose a new term "Hypoxic-Ischemic Enterocolitis (HIEnt)" for the definition and differentiation of this unique clinical entity.
Necrotizing enterocolitis is associated with neonatal intestinal injury
Journal of Pediatric Surgery, 2011
PURPOSE: We hypothesized that a subset of premature newborns has subclinical, intestinal mucosal compromise that predisposes to the development of necrotizing enterocolitis (NEC) days or weeks later. METHODS: Fifty-five newborns of 23 to 36 weeks' gestational age were identified, and urine was collected over the first 90 hours of life. The urinary concentration of intestinal fatty acid binding protein (iFABP(u)), a sensitive marker for intestinal injury, was determined. The diagnosis of NEC was based upon clinical condition, pathology, and/or imaging findings. RESULTS: Neonatal iFABP(u) exceeded 800 pg/mL in 27 subjects, including 9 of 9 who subsequently developed stage 2 or 3 NEC. This degree of iFABP(u) elevation, but not asphyxia, was significantly associated with the development of NEC (P < .01). CONCLUSION: In this population of premature newborns, there was a substantial incidence of intestinal mucosal compromise. All infants who subsequently developed stage 2 or 3 NEC had an elevated iFABP(u). This finding suggests a model for the pathogenesis of some cases of NEC, whereby perinatal mucosal injury predisposes to further damage when feedings are initiated. In addition, neonatal iFABP(u) assessment may represent a tool to identify infants at the highest risk for NEC and allow for the institution of focused, preventive measures.
Neonatal necrotizing enterocolitis: an overview
Current Opinion in Infectious Diseases, 2003
Necrotizing enterocolitis represents a disease entity that remains quite challenging for neonatologists all around the world, in that its aetiology has yet to be revealed, but it is the cause of death for many premature infants each year, affecting up to 28% of very low birthweight infants. This is an attempt to improve the management of affected babies and stimulate more research concerning new diagnostic tools.
Early diagnosis of necrotizing enterocolitis of the newborn
Journal of Pediatric Surgery, 1975
Pediatrics and Neonatology xxx (xxxx) xxx significant difference was found in plasma Resistin levels between two groups (P > 0.05). If platelet level was less than 157 Â 10 9 /L, the sensitivity and specificity were 69.34% and 82.87%, respectively. Interestingly, the combination of RELMb and thrombocytopenia increased sensitivity and specificity to 82.89% and 93.21%, respectively. Conclusion: The combination of RELMb and thrombocytopenia was a reliable biomarker for the early diagnosis of NEC in this study with 82.89% sensitivity and 93.21% specificity, respectively.
Radiological findings associated with the death of newborns with necrotizing enterocolitis
Radiologia brasileira
The aim of this study was to identify radiological and clinical risk factors for death in newborns with necrotizing enterocolitis. This was a retrospective cohort study, based on radiological examinations and medical charts of 66 infants with necrotizing enterocolitis, as confirmed by a finding of intestinal pneumatosis (stage IIA, according to modified Bell's staging criteria). Radiological and clinical variables were evaluated. Of the 66 infants evaluated, 14 (21.2%) presented pneumatosis in the large and small bowel; 7 (10.6%) presented air in the portal system; and 12 (18.2%) died. Bivariate analysis revealed that the following variables were associated with death: bowel perforation; pneumatosis in the large and small bowel; air in the portal system; earlier gestational age; longer time on mechanical ventilation before the identification of pneumatosis; and longer time on mechanical ventilation before discharge or death. In the multivariate regression, the following variable...