Cord blood KL-6, a specific lung injury marker, correlates with the subsequent development and severity of atypical bronchopulmonary dysplasia.
BACKGROUND
A considerable number of preterm infants may have been exposed to inflammation in utero and may be born with an inflamed lung.


OBJECTIVE
To determine the impact of antenatal lung injury and inflammatory response on the pathogenesis of bronchopulmonary dysplasia (BPD) according to its clinical pattern, using KL-6 (as a lung injury marker) and C-reactive protein (CRP) (as a marker of inflammatory response).


METHODS
In this case-control study, a total of 74 infants (<32 weeks of gestation) including BPD with minimal early lung disease ('atypical'; 21 infants), BPD with significant early lung disease ('classic'; 29 infants) and the non-BPD (24 infants) groups underwent KL-6 and CRP in cord blood determinations.


RESULTS
The cord plasma KL-6 levels were significantly higher in the atypical and the total BPD groups than in the non-BPD group (median = 60.9 vs. 34.5 U/ml, p = 0.031; 43.5 vs. 34.5 U/ml, p = 0.02). However, the cord plasma CRP levels were not significantly different among the study groups. The cord plasma KL-6 levels in patients with atypical BPD were significantly higher in infants with moderate or severe BPD than in infants with mild BPD (median = 88.3 vs. 41.5 U/ml, p = 0.041) and were found to be significantly correlated with the duration of oxygen therapy (r = 0.502, p = 0.024).


CONCLUSIONS
The present study shows that cord plasma KL-6, a specific lung injury marker, is increased and objectively reflects disease severity in atypical BPD.
Kim
Do-Hyun
DH
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Kim
Han-Suk
HS
Shim
So-Yeon
SY
Lee
Jin-A
JA
Choi
Chang Won
CW
Kim
Ee-Kyung
EK
Kim
Beyong Il
BI
Choi
Jung-Hwan
JH
D015415:Biomarkers / Q000097:blood; D001997:Bronchopulmonary Dysplasia / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D018396:Mucin-1 / Q000097:blood*
D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; D002097:C-Reactive Protein