P-selectin expression, neutrophil infiltration, and histologic injury in neonates with necrotizing enterocolitis.
OBJECTIVE
P-selectin promotes adherence of leukocytes to the endothelium in inflammatory processes. The aim of this study was to investigate the expression of P-selectin and its role in the development of inflammation in neonates with necrotizing enterocolitis (NEC).


METHODS
Twenty-nine intestinal specimens from 13 neonates with NEC and 7 control neonates with congenital gastrointestinal abnormalities were studied. Histologic damage, immunohistochemical expression of P-selectin, and polymorphonuclear cell infiltrate were graded blindly. Mann-Whitney U and Spearman rank tests were used to compare grades.


RESULTS
Expression of P-selectin was increased in NEC compared with controls in both medium-sized vessels (P = .03) and in the microcirculation (P = .03). P-selectin expression on medium-sized vessels correlated with the degree of histologic injury (P = .02, r = 0.425). P-selectin expression was greatest in areas of active inflammation but markedly lower in necrotic areas. The degree of polymorphonuclear cell infiltration strongly correlated with P-selectin expression on both medium-sized vessels (P = .004, r = 0.513) and the microcirculation (P = .001, r = 0.578).


CONCLUSIONS
Expression of P-selectin is increased in medium-sized vessels and in the microcirculation in intestinal specimens of neonates with NEC compared with neonatal controls. Expression of P-selectin is associated with the recruitment of polymorphonuclear cells and the severity of histologic injury, although P-selectin expression is lost in necrotic tissue.
Stefanutti
Giorgio
G
Department of Paediatric Surgery, Institute of Child Health and Great Ormond Street Hospital, WC1N 1EH London, UK.
Lister
Paula
P
Smith
Virpi V
VV
Peters
Mark J
MJ
Klein
Nigel J
NJ
Pierro
Agostino
A
Eaton
Simon
S
D020345:Enterocolitis, Necrotizing / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007249:Inflammation / Q000378:metabolism* / Q000473:pathology; D007413:Intestinal Mucosa / Q000098:blood supply / Q000276:immunology / Q000473:pathology*; D019272:Leukocyte Elastase / Q000032:analysis; D008833:Microcirculation / Q000378:metabolism; D020556:Neutrophil Infiltration; D019007:P-Selectin / Q000378:metabolism*; D040201:Platelet Membrane Glycoprotein IIb / Q000032:analysis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D019007:P-Selectin; D040201:Platelet Membrane Glycoprotein IIb; D019272:Leukocyte Elastase