Epithelial Lining Fluid Neutrophil-Gelatinase-Associated Lipocalin Levels in Premature Newborns with Bronchopulmonary Dysplasia and Patency of Ductus Arteriosus

Abstract

Patency of the ductus arteriosus (PDA) and bronchopulmonary dysplasia (BPD) development represent severe affections for premature newborns, therefore the research of early markers for these two conditions is really important. The aim of this study is to analyze epithelial lining fluid (ELF) Neutrophil-gelatinase-associated lipocalin (NGAL) levels for prediction of lung injury or possible involvement ofthis molecule in PDA. Only scarce and contrasting results have previously been published in this field. In contrast, this molecule, included in a large macromolecular complex together with matrix metalloproteinase-9 (MMP-9), is considered an acceptable marker of infectious/inflammatory processes, cancer monitoring and induction of apoptotic pathway. NGAL was detected in 28 pre-term newborns by means of a commercially available kit in bronchoalveolar lavage fluid (BALF). The results have been corrected to ELF levels, by the urea method, to eliminate bias due to BALF collection. ELF NGAL levels were found significantly increased both in infants developing BPD or in those affected by PDA. By means of multivariate logistic regression analysis the significances were confirmed after adjusting for possible interfering variables such as gestational age and concomitant presence of both PDA and BPD. Our results stress the involvement of NGAL in the mechanisms leading to BPD and also suggest a possible association with PDA, which is often linked to prematurity and BPD development, probably due to the involvement of inflammatory and angiogenetic processes in both pathologies.Neutrophil-gelatinase-associated lipocalin (NGAL) is a 25-kDa protein associated with neutrophil ge1atinase, a molecular complex of 220-kDa, (namely matrix metallo-protein-9, MMP-9) including a homodimer of the gelatinase component (92-kDa) and the NGAL protein (l). NGAL is present in monocyte/macrophage cell lineage, in hepatocyte, epithelial and immune cells. It has been shown to increase in inflammatory and neoplastic diseases and has been proposed as a kidney injury marker (2). The NGAL functions mainly depend on its binding activity, directed against various molecules, such as N-formylated tripeptides, fatty acids, leukotriene B4 and platelet activating factor (3) as well as plasma matrix metallo-protein MMP-9 (4). In particular, when bound to MMP-9, NGAL may modulate

Urinary NT-proBNP, NGAL, and H-FABP May Predict Hemodynamic Relevance of Patent Ductus Arteriosus in Very Low Birth Weight Infants

“…These authors also observed a correlation between high urinary NGAL levels and low gestational age. Capoluongo et al [17] found a significant correlation between NGAL concentrations in bronchopulmonary lavage and the presence of PDA. Using NGAL as a marker for the hemodynamic relevance of PDA, as done in our study, had not been addressed by these authors.…”

“…NT-proBNP is supposed to represent a cardiac marker of hypoperfusion, H-FABP a potential marker of cardiac and intestinal hypoperfusion [15,16] . Increased levels of NGAL were hypothesized to indicate renal hypoperfusion as a result of a steal phenomenon caused by re-circulation of blood across an open duct, thus negatively affecting blood flow to the kidneys [12,17] .…”

Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a New Biomarker for Non – Acute Kidney Injury (AKI) Diseases

“…NGAL levels in lung epithelial lining fluid were significantly higher in patients with patency of the ductus arteriosus and bronchopulmonary dysplasia, which provided a link of inflammation and angiogenetic processes in both pathologies [67]. Similarly, plasma NGAL was up-regulated in -thalassemia which might be due to the possible association of oxidative stress [68].…”

Biomarkers, Early Diagnosis, and Clinical Predictors of Bronchopulmonary Dysplasia

“…74 Neutrophil-gelatinase-associated lipocalin (NGAL) included in a large macromolecular complex together with matrix metalloproteinase-9 (MMP-9), is considered a marker of infectious/inflammatory processes and induction of apoptosis. In a study by Capoluongo et al 75 , NGAL was increased both in infants developing BPD and in those with a patent ductus arteriosus (PDA) even after adjustment for possible confounders.…”