title: M-ficolin in the neonatal period: Associations with need for mechanical ventilation and mortality in premature infants with necrotising enterocolitis.
abstract: 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.
authors.affiliation: Department of Pediatrics, Inselspital, University of Bern, Switzerland. luregn.schlapbach@insel.ch
authors.forename: Luregn J
authors.initials: LJ
authors.lastname: Schlapbach
authors.forename: Ulf
authors.initials: U
authors.lastname: Kessler
authors.forename: Steffen
authors.initials: S
authors.lastname: Thiel
authors.forename: Annette G
authors.initials: AG
authors.lastname: Hansen
authors.forename: Mathias
authors.initials: M
authors.lastname: Nelle
authors.forename: Roland A
authors.initials: RA
authors.lastname: Ammann
authors.forename: Christoph
authors.initials: C
authors.lastname: Aebi
authors.forename: Jens C
authors.initials: JC
authors.lastname: Jensenius
mesh_terms: 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
chemical_list: D037102:Lectins; D012333:RNA, Messenger; D000097604:Ficolins