M-ficolin in the neonatal period: associations with need for mechanical ventilation and mortality in premature infants with necrotising enterocolitis

Schlapbach, Luregn J., Kessler, Ulf, Thiel, Steffen, Hansen, Annette G., Nelle, Mathias, Ammann, Roland A., Aebi, Christoph and Jensenius, Jens C. (2009) M-ficolin in the neonatal period: associations with need for mechanical ventilation and mortality in premature infants with necrotising enterocolitis. Molecular Immunology, 46 13: 2597-2603. doi:10.1016/j.molimm.2009.05.003


Author Schlapbach, Luregn J.
Kessler, Ulf
Thiel, Steffen
Hansen, Annette G.
Nelle, Mathias
Ammann, Roland A.
Aebi, Christoph
Jensenius, Jens C.
Title M-ficolin in the neonatal period: associations with need for mechanical ventilation and mortality in premature infants with necrotising enterocolitis
Journal name Molecular Immunology   Check publisher's open access policy
ISSN 0161-5890
1872-9142
Publication date 2009
Sub-type Article (original research)
DOI 10.1016/j.molimm.2009.05.003
Open Access Status
Volume 46
Issue 13
Start page 2597
End page 2603
Total pages 7
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon
Language eng
Subject 1312 Molecular Biology
2403 Immunology
Formatted 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.

Study design: 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 <300 ng/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. 
Keyword Complement
Ficolin
Necrotising enterocolitis
Premature infant
Ventilation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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