title: Serial changes of serum endostatin and angiopoietin-1 levels in preterm infants with severe bronchopulmonary dysplasia and subsequent pulmonary artery hypertension.
abstract: BACKGROUND
  In bronchopulmonary dysplasia (BPD), disrupted angiogenesis may result from an imbalance between pro- and anti-angiogenic factors triggered by inflammation, leading to the late development of pulmonary artery hypertension (PAH).
  
  
  OBJECTIVE
  To investigate whether the levels of serum endostatin (as an anti-angiogenic factor) and angiopoietin-1 (AP-1; as a pro-angiogenic factor) in early life are associated with the development of PAH in preterm infants with severe BPD.
  
  
  METHODS
  In this prospective cohort study, the levels of serum endostatin and AP-1 were measured from 56 infants (gestational age <30 weeks or birth weight <1,250 g) including severe BPD with PAH ('PAH'; 15 infants) or without PAH ('non-PAH'; 22 infants) and no/mild BPD (19 infants) groups on days 1, 7, 14, and 28 of life.
  
  
  RESULTS
  The PAH group consistently underwent more aggressive respiratory management than the non-PAH group, over 1 month after birth. The endostatin level and the ratio of endostatin to AP-1 on day 7 of life were significantly higher in the PAH group than in the non-PAH group or no/mild BPD groups (median 146.6 vs. 102.4/108.0 ng/ml; 62.1 vs. 18.6/14.9). The ratio of endostatin to AP-1 on day 1 was also significantly higher in the PAH group than in the no/mild BPD group (median 31.8 vs. 11.3).
  
  
  CONCLUSIONS
  An increased serum endostatin to AP-1 ratio may reflect impaired angiogenesis that may lead to the development of PAH [corrected].
authors.affiliation: Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Do-Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Han-Suk
authors.initials: HS
authors.lastname: Kim
mesh_terms: D042683:Angiopoietin-1 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001997:Bronchopulmonary Dysplasia / Q000097:blood* / Q000503:physiopathology; D015331:Cohort Studies; D043169:Endostatins / Q000097:blood*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000503:physiopathology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: C467630:ANGPT1 protein, human; D042683:Angiopoietin-1; D015415:Biomarkers; D043169:Endostatins