Zepeda-Romero Luz Consuelo, Vazquez-Membrillo Miguel, Adan-Castro Elva, Gomez-Aguayo Francisco, Gutierrez-Padilla Jose Alfonso, Angulo-Castellanos Eusebio, Barrera de Leon Juan Carlos, Gonzalez-Bernal Cesareo, Quezada-Chalita Manuel Alejandro, Meza-Anguiano Alonso, Diaz-Lezama Nundehui, Martinez de la Escalera Gonzalo, Triebel Jakob, Clapp Carmen
Hospital Civil "Fray Antonio Alcalde", Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.
Institute of Neurobiology, National University of Mexico (UNAM), Querétaro, Mexico.
Pediatr Res. 2017 Mar;81(3):473-479. doi: 10.1038/pr.2016.241. Epub 2016 Nov 14.
Retinopathy of prematurity (ROP) is a potentially blinding, retinal neovascular disease. Systemic prolactin accesses the retina to regulate blood vessels. Prolactin is proangiogenic and can be cleaved to antiangiogenic vasoinhibins. We investigated whether circulating prolactin and vasoinhibins associate with incidence and progression of ROP.
A prospective, longitudinal, case-control study covering postnatal weeks 1 to 9 measured serum prolactin, vasoinhibins, and vascular endothelial growth factor (VEGF) weekly in 90 premature infants diagnosed as ROP or control.
Prolactin levels were higher in ROP than in control patients before (106.2 ± 11.3 (SEM) vs. 64.7 ± 4.9 ng/ml, postnatal week 1) and during (120.6 ± 10 vs. 84.7 ± 7.5ng/ml, postnatal week 5) ROP diagnosis. Prolactin, but not gestational age, birth weight, Apgar score, sepsis, or ventilation time, correlated with ROP. The relative risk (RR) of developing ROP increased if Prolactin (PRL) levels were higher than thresholds of 80 ng/ml (RR = 1.55, 95% CI: 1.06-2.28), 100 ng/ml (RR = 1.63, 95% CI: 1.14-2.34), or 120 ng/ml (RR = 1.95, 95% CI: 1.41-2.68). Vasoinhibin levels were 39.7% higher (95% CI: 4.5-77.5) in the circulation of ROP than in control patients at postnatal week 1 and similar thereafter, whereas VEGF serum levels were always similar.
High serum prolactin and vasoinhibin levels predict and may impact ROP progression.
早产儿视网膜病变（ROP）是一种可能导致失明的视网膜新生血管疾病。全身性催乳素可进入视网膜以调节血管。催乳素具有促血管生成作用，且可裂解为抗血管生成的血管抑制素。我们研究了循环中的催乳素和血管抑制素是否与ROP的发病率及病情进展相关。
一项前瞻性、纵向、病例对照研究涵盖出生后第1至9周，每周对90例诊断为ROP的早产儿或对照早产儿测定血清催乳素、血管抑制素和血管内皮生长因子（VEGF）。
在ROP诊断前（出生后第1周，106.2±11.3（SEM）对64.7±4.9 ng/ml）及诊断期间（出生后第5周，120.6±10对84.7±7.5 ng/ml），ROP患者的催乳素水平高于对照患者。催乳素与ROP相关，而胎龄、出生体重、阿氏评分、败血症或通气时间与ROP无关。如果催乳素（PRL）水平高于80 ng/ml（相对危险度（RR）=1.55，95%可信区间：1.06 - 2.28）、100 ng/ml（RR = 1.63，95%可信区间：1.14 - 2.34）或120 ng/ml（RR = 1.95，95%可信区间：1.41 - 2.68），发生ROP的相对危险度增加。出生后第1周，ROP患者循环中的血管抑制素水平比对照患者高39.7%（95%可信区间：4.5 - 77.5），此后相似，而VEGF血清水平始终相似。
高血清催乳素和血管抑制素水平可预测并可能影响ROP进展。
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