粪便人β-防御素2和紧密连接蛋白3可能是预测坏死性小肠结肠炎病情恶化的潜在生物标志物：一项前瞻性研究。

Fecal HBD-2 and Claudin-3 may be potential biomarkers to predict the deterioration of necrotizing enterocolitis: A prospective study.

作者信息

Liu Xiao-Chen, Li Lu-Quan, Ling Ke-Ran, Guo Lu, Hu Xiao-Yu, Li Chun

机构信息

Neonatal Diagnosis and Treatment Centre of Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.

出版信息

Front Pediatr. 2022 Dec 13;10:1062798. doi: 10.3389/fped.2022.1062798. eCollection 2022.

DOI:10.3389/fped.2022.1062798

PMID:36582510

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9794018/

Abstract

BACKGROUND AND PURPOSE

Necrotizing enterocolitis (NEC) is a critical gastrointestinal disease. We aim to explore the value of fecal human β-defensin 2 (HBD-2), Claudin-3, high-mobility group box-1 protein (HMGB-1), and resistin-like molecule β (Relmβ) as well as some laboratory metrics to predict the deterioration of NEC.

METHODS

Infants diagnosed with NEC at Stage II were enrolled in our study. Those who progressed to Stage III were included in the Stage III group and the rest were included in the Stage II group. Clinical data and laboratory metrics of the infants were collected. Fecal samples of HBD2, HMGB-1, Claudin-3, and Relmβ collected during their enrollment were determined by using enzyme-linked immunosorbent assay (ELISA) kits. Student's t-test, the Mann-Whitney U test, the chi-square test, receiver operating characteristic (ROC), and logistic regression analysis were performed.

RESULTS

Sixty infants diagnosed with NEC at Stage II were enrolled in our study, with 27 in the Stage III group ( = 27) and 33 in the Stage II group ( = 33). Although many of these NEC cases were late preterm and term infants, the infants in the Stage III group had a lower gestational age (< 0.05). The incidence of gestational diabetes mellitus, peritonitis, intestinal adhesion, and sepsis was higher and more infants in the Stage III group underwent surgeries (< 0.05). The levels of HBD-2 and Claudin-3 were higher and neutrophil count was lower in the Stage III group than in the Stage II Group, and the area under the curve (AUC) was 0.754, 0,755, and 0.666, respectively (< 0.05). HBD-2 ≥ 1649.02 ng/g and Claudin-3 ≥ 2488.71 pg/g were included in the multivariate stepwise logistic regression analysis (< 0.05), and the AUC of the model was 0.805 (95% CI: 0.688-0.922).

CONCLUSION

Fecal HBD-2 and Claudin-3 may be potential biomarkers to predict the deterioration of NEC from Stage II to Stage III.

摘要

背景与目的

坏死性小肠结肠炎（NEC）是一种严重的胃肠道疾病。我们旨在探讨粪便人β-防御素2（HBD-2）、Claudin-3、高迁移率族蛋白B1（HMGB-1）和抵抗素样分子β（Relmβ）以及一些实验室指标对预测NEC病情恶化的价值。

方法

纳入诊断为II期NEC的婴儿。进展至III期的婴儿纳入III期组，其余纳入II期组。收集婴儿的临床资料和实验室指标。采用酶联免疫吸附测定（ELISA）试剂盒检测其入组时采集的粪便样本中的HBD2、HMGB-1、Claudin-3和Relmβ。进行学生t检验、曼-惠特尼U检验、卡方检验、受试者工作特征（ROC）分析和逻辑回归分析。

结果

60例诊断为II期NEC的婴儿纳入本研究，其中III期组27例（=27），II期组33例（=33）。尽管这些NEC病例大多为晚期早产儿和足月儿，但III期组婴儿的胎龄较低（<0.05）。III期组妊娠糖尿病、腹膜炎、肠粘连和败血症的发生率较高，且接受手术的婴儿更多（<0.05）。III期组的HBD-2和Claudin-3水平较高，中性粒细胞计数低于II期组，曲线下面积（AUC）分别为0.754、0.755和0.666（<0.05）。多因素逐步逻辑回归分析纳入HBD-2≥1649.02 ng/g和Claudin-3≥2488.71 pg/g（<0.05），模型的AUC为0.805（95%CI：0.688-0.922）。