Plasma Proendothelin-1 as an Early Marker of Bronchopulmonary Dysplasia.
BACKGROUND
Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants. Clinical prediction of BPD at an early stage in life is difficult. Plasma proendothelin-1 (CT-proET-1) is a lung injury biomarker in pulmonary hypertension and respiratory distress.


OBJECTIVE
To assess the prognostic ability of CT-proET-1 in BPD.


METHODS
In 227 prospectively enrolled preterm infants born at <32 weeks gestational age (GA), plasma CT-proET-1 was measured at birth, day of life (DOL) 2, 3, 6 and 28, and at 36 weeks postmenstrual age (PMA). BPD was defined as mild in infants requiring supplemental oxygen at DOL 28 and moderate/severe in those requiring it at 36 weeks PMA.


RESULTS
The predictive ability of CT-proET-1 for any BPD was poor at birth [area under the ROC curve (AUC) 0.654, 95% CI 0.494-0.814], moderate at DOL 2 and 3 (AUC 0.769, 95% CI 0.666-0.872) and excellent at DOL 6 (AUC 0.918, 95% CI 0.840-0.995). Multivariable regression analysis revealed that CT-proET-1 levels at DOL 2, 3, 6 and 28 were strongly related to the duration of oxygen supplementation, independently of GA and the duration of respiratory support.


CONCLUSIONS
CT-proET-1 is a novel promising biomarker for predicting the development of BPD in preterm infants when measured at the end of the first week of life.
Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Philipp
P
Baumann
Sotirios
S
Fouzas
Isabelle
I
Pramana
Beate
B
Grass
Oliver
O
Niesse
Christoph
C
Bührer
Katharina
K
Spanaus
Sven
S
Wellmann
D015415:Biomarkers / Q000097:blood; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis*; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D015999:Multivariate Analysis; D010100:Oxygen / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012044:Regression Analysis
D015415:Biomarkers; C557077:C-terminal proendothelin-1; D019332:Endothelin-1; D010446:Peptide Fragments; D010100:Oxygen