M-ficolin in the neonatal period: Associations with need for mechanical ventilation and mortality in premature infants with necrotising enterocolitis.
OBJECTIVE
Necrotising enterocolitis (NEC) causes significant mortality in premature infants. The involvement of the innate immune system in the pathogenesis of NEC remains unclear. M-, L- and H-ficolins recognize microorganisms and activate the complement system, but their role in host defense is largely unknown. This study investigated whether ficolin concentrations are associated with NEC.


METHODS
Case-control study including 30 premature infants with NEC and 60 controls. M-, L- and H-ficolins were measured in cord blood using time-resolved immunofluorometric assays. Multivariate logistic regression was performed.


RESULTS
Of the 30 NEC cases (median gestational age, 29.5 weeks), 12 (40%) were operated and 4 (13%) died. No difference regarding ficolin concentration was found when comparing NEC cases versus controls (p>0.05). However, infants who died of NEC had significantly lower M-ficolin cord blood concentrations than NEC survivors (for M-ficolin <300ng/ml; multivariate OR 12.35, CI 1.03-148.59, p=0.048). In the entire study population, M-, L- and H-ficolins were positively correlated with gestational age (p<0.001) and birth weight (p<0.001). Infants with low M-ficolin required significantly more often mechanical ventilation after birth multivariate (OR 10.55, CI 2.01-55.34, p=0.005).


CONCLUSIONS
M-, L- and H-ficolins are already present in cord blood and increase with gestational age. Low cord blood concentration of M-ficolin was associated with higher NEC-associated fatality and with increased need for mechanical ventilation. Future studies need to assess whether M-ficolin is involved in multiorgan failure and pulmonary disease.
Schlapbach
Luregn J
LJ
Department of Pediatrics, Inselspital, University of Bern, Switzerland. luregn.schlapbach@insel.ch
Kessler
Ulf
U
Thiel
Steffen
S
Hansen
Annette G
AG
Nelle
Mathias
M
Ammann
Roland A
RA
Aebi
Christoph
C
Jensenius
Jens C
JC
D015153:Blotting, Western; D016022:Case-Control Studies; D002460:Cell Line; D020345:Enterocolitis, Necrotizing / Q000097:blood* / Q000401:mortality / Q000628:therapy; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D037102:Lectins / Q000032:analysis / Q000097:blood* / Q000235:genetics; D016015:Logistic Models; D008264:Macrophages / Q000166:cytology / Q000378:metabolism; D016676:Macrophages, Alveolar / Q000166:cytology / Q000378:metabolism; D009000:Monocytes / Q000166:cytology / Q000378:metabolism; D015999:Multivariate Analysis; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012121:Respiration, Artificial; D020133:Reverse Transcriptase Polymerase Chain Reaction; D000097604:Ficolins
D037102:Lectins; D012333:RNA, Messenger; D000097604:Ficolins