Go Hayato, Ohto Hitoshi, Nollet Kenneth E, Sato Kenichi, Miyazaki Kyohei, Maeda Hajime, Ichikawa Hirotaka, Chishiki Mina, Kashiwabara Nozomi, Kume Yohei, Ogasawara Kei, Sato Maki, Hosoya Mitsuaki
Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
Fukushima Medical University, Fukushima, Japan.
Front Pediatr. 2021 Apr 29;9:649526. doi: 10.3389/fped.2021.649526. eCollection 2021.
Bronchopulmonary dysplasia (BPD) is a common cause of pulmonary disease in preterm infants. The soluble receptor for advanced glycation end products (sRAGE) is implicated in the development of various pulmonary diseases. The objectives of the current study were to investigate perinatal factors associated with serum sRAGE levels at birth and to establish whether serum sRAGE could be a biomarker for BPD. This retrospective single-center study was conducted at Fukushima Medical University Hospital's Department of Pediatrics Neonatal Intensive Care Unit from April 2014 to September 2020. Mechanically ventilated or oxygenated neonates born at <32 weeks gestational age and healthy control neonates were included in this study. Serum sRAGE levels in cord blood were measured using an enzyme-linked immunosorbent assay. Eighty-four preterm infants born at <32 weeks and 40 healthy infants were identified. The 84 born at <32 weeks were categorized as BPD ( = 34) or non-BPD ( = 50) neonates. The median gestational age (GA) and birthweight (BW) were significantly lower in BPD vs. non-BPD neonates (24.4 vs. 27.6 weeks, < 0.001, 634 vs. 952 g, < 0.001, respectively). Serum sRAGE at birth in all 124 preterm and term infants significantly correlated with BW ( = 0.417, < 0.0001) and GA ( = 0.415, < 0.0001). Among those born at <32 weeks, median serum sRAGE levels at birth were significantly lower in infants with BPD than without (1,726 vs. 2,797 pg/mL, = 0.0005). Receiver operating characteristic analysis for sRAGE levels at birth in infants with and without BPD revealed that the area under the curve was 0.724 (95% confidence interval 0.714-0.834, = 0.001). However, serum RAGE levels were not associated with severity of BPD. Serum sRAGE levels at birth were significantly correlated with BW and GA. Furthermore, serum sRAGE levels at birth could serve as a biomarker for predicting BPD, but not its severity.
支气管肺发育不良(BPD)是早产儿肺部疾病的常见病因。晚期糖基化终产物可溶性受体(sRAGE)与多种肺部疾病的发生有关。本研究的目的是调查与出生时血清sRAGE水平相关的围产期因素,并确定血清sRAGE是否可作为BPD的生物标志物。这项回顾性单中心研究于2014年4月至2020年9月在福岛医科大学附属医院儿科新生儿重症监护病房进行。本研究纳入了孕周<32周的机械通气或吸氧新生儿以及健康对照新生儿。采用酶联免疫吸附测定法测量脐血中的血清sRAGE水平。共确定了84例孕周<32周的早产儿和40例健康婴儿。84例孕周<32周的婴儿被分为BPD(n = 34)或非BPD(n = 50)新生儿。与非BPD新生儿相比,BPD新生儿的中位孕周(GA)和出生体重(BW)显著更低(分别为24.4周对27.6周,P < 0.001;634 g对952 g,P < 0.001)。所有124例早产儿和足月儿出生时的血清sRAGE水平与BW(r = 0.417,P < 0.0001)和GA(r = 0.415,P < 0.0001)显著相关。在孕周<32周出生的婴儿中,BPD婴儿出生时的血清sRAGE中位水平显著低于非BPD婴儿(1726对2797 pg/mL,P = 0.0005)。对有或无BPD婴儿出生时sRAGE水平进行的受试者工作特征分析显示,曲线下面积为0.724(95%置信区间0.714 - 0.834,P = 0.001)。然而,血清RAGE水平与BPD的严重程度无关。出生时的血清sRAGE水平与BW和GA显著相关。此外,出生时的血清sRAGE水平可作为预测BPD的生物标志物,但不能预测其严重程度。