Fucosyltransferase 2 non-secretor and low secretor status predicts severe outcomes in premature infants.
OBJECTIVE
To investigate secretor gene fucosyltransferase 2 (FUT2) polymorphism and secretor phenotype in relation to outcomes of prematurity.


METHODS
Study infants were ≤32 weeks gestational age. Secretor genotype was determined from salivary DNA. Secretor phenotype was measured with H antigen, the carbohydrate produced by secretor gene enzymes, in saliva samples collected on day 9 ± 5. The optimal predictive cutoff point in salivary H values was identified with Classification and Regression Tree analysis. Study outcomes were death, necrotizing enterocolitis (NEC, Bell's stage II/III), and confirmed sepsis.


RESULTS
There were 410 study infants, 26 deaths, 30 cases of NEC, and 96 cases of sepsis. Analyzed by genotype, 13% of 95 infants who were non-secretors, 5% of 203 infants who were heterozygotes, and 2% of 96 infants who were secretor dominant died (P = .01). Analyzed by phenotype, 15% of 135 infants with low secretor phenotype died, compared with 2% of 248 infants with high secretor phenotype (predictive value = 76%, P < .001). Low secretor phenotype was associated (P < .05) with NEC, and non-secretor genotype was associated (P = .05) with gram negative sepsis. Secretor status remained significant after controlling for multiple clinical factors.


CONCLUSIONS
Secretor genotype and phenotype may provide strong predictive biomarkers of adverse outcomes in premature infants.
Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45213, USA. Ardythe.Morrow@cchmc.org
Ardythe L
AL
Morrow
Jareen
J
Meinzen-Derr
Pengwei
P
Huang
Kurt R
KR
Schibler
Tanya
T
Cahill
Mehdi
M
Keddache
Suhas G
SG
Kallapur
David S
DS
Newburg
Meredith
M
Tabangin
Barbara B
BB
Warner
Xi
X
Jiang
D002423:Cause of Death / Q000639:trends; D004247:DNA / Q000235:genetics*; D020345:Enterocolitis, Necrotizing / Q000201:enzymology / Q000235:genetics / Q000401:mortality; D005500:Follow-Up Studies; D005647:Fucosyltransferases / Q000235:genetics* / Q000378:metabolism; D005838:Genotype; D006801:Humans; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D007234:Infant, Premature; D009820:Ohio / Q000453:epidemiology; D011110:Polymorphism, Genetic; D011379:Prognosis; D012189:Retrospective Studies; D012463:Saliva / Q000201:enzymology; D000097631:Galactoside 2-alpha-L-fucosyltransferase
D004247:DNA; D005647:Fucosyltransferases; D000097631:Galactoside 2-alpha-L-fucosyltransferase
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