Urine bombesin-like peptide elevation precedes clinical evidence of bronchopulmonary dysplasia.
Bronchopulmonary dysplasia (BPD) is a chronic lung disease of very low birth weight infants, associated with oxygen therapy, barotrauma, and/or infections. Improved medical care has led to a paradoxically increased incidence of BPD due to greater infant survival. Early prediction of BPD has proven challenging. Increased pulmonary neuroendocrine cells containing bombesin-like peptide immunoreactivity occur in infants with BPD. We hypothesized that elevated urine bombesin-like peptide levels precede BPD. One hundred thirty-two infants, 28-weeks gestation or less, were studied. Urine bombesin-like peptide levels, determined by radioimmunoassay, were normalized for creatinine. BPD was defined as oxygen dependence at 36 weeks postmenstrual age. A first urine bombesin-like peptide level greater than 20,000 pg/mg creatinine (12,500 fmol/mg) between postnatal days 1-4 occurred among 54% of the infants who later developed BPD (p < or = 0.001), versus 10% among non-BPD infants (specificity 90%). Multivariable logistic regression analyses revealed that elevated urine bombesin-like peptide levels are associated with BPD (odds ratio 9.9, 95% confidence interval: 3.4, 29) (p < or = 0.001) after adjusting for all confounding factors. Thus, elevated bombesin-like peptide levels in these infants at 1-4 days after birth are associated with a 10-fold increased risk of developing BPD. Utilizing urine bombesin-like peptide for screening might permit early therapeutic interventions to reduce disease progression and could provide a target for new preventive therapies.
Cullen
Anne
A
Children's Hospital, Department of Pathology, Boston, Massachusetts 02115, USA.
Van Marter
Linda J
LJ
Allred
Elizabeth N
EN
Moore
Marianne
M
Parad
Richard B
RB
Sunday
Mary E
ME
D015415:Biomarkers / Q000652:urine; D001839:Bombesin / Q000652:urine*; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis* / Q000628:therapy / Q000652:urine; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000652:urine; D016015:Logistic Models; D008297:Male; D012121:Respiration, Artificial; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015415:Biomarkers; D001839:Bombesin