Serum eotaxin-1 is increased in extremely-low-birth-weight infants with bronchopulmonary dysplasia or death.
BACKGROUND
Early systemic inflammation in extremely-low-birth-weight (ELBW) infants is associated with an increased risk of bronchopulmonary dysplasia (BPD). Our objective was to identify circulating biomarkers and develop prediction models for BPD/death soon after birth.


METHODS
Blood samples from postnatal day 1 were analyzed for C-reactive protein (CRP) by enzyme-linked immunosorbent assay and for 39 cytokines/chemokines by a multiplex assay in 152 ELBW infants. The primary outcome was physiologic BPD or death by 36 wk. CRP, cytokines, and clinical variables available at ≤24 h were used for forward stepwise regression and Classification and Regression Tree (CART) analysis to identify predictors of BPD/death.


RESULTS
Overall, 24% developed BPD and 35% died or developed BPD. Regression analysis identified birth weight and eotaxin (CCL11) as the two most significant variables. CART identified FiO2 at 24 h (11% BPD/death if FiO2 ≤28%, 49% if >28%) and eotaxin in infants with FiO2 > 28% (29% BPD/death if eotaxin was ≤84 pg/ml; 65% if >84) as variables most associated with outcome.


CONCLUSIONS
Eotaxin measured on the day of birth is useful for identifying ELBW infants at risk of BPD/death. Further investigation is required to determine if eotaxin is involved in lung injury and pathogenesis of BPD.
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Jegen
J
Kandasamy
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Claire
C
Roane
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Alexander
A
Szalai
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Namasivayam
http://orcid.org/0000-0003-0731-9092
N
Ambalavanan
D000367:Age Factors; D015415:Biomarkers / Q000097:blood*; D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D002097:C-Reactive Protein / Q000032:analysis; D054413:Chemokine CCL11 / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
D015415:Biomarkers; C515456:CCL11 protein, human; D054413:Chemokine CCL11; D002097:C-Reactive Protein