Plasma Proendothelin-1 as an Early Marker of Bronchopulmonary Dysplasia

Abstract

Background: Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants. Clinical prediction of BPD at an early stage in life is difficult. Plasma proendothelin-1 (CT-proET-1) is a lung injury biomarker in pulmonary hypertension and respiratory distress. Objective: To assess the prognostic ability of CT-proET-1 in BPD. Methods: In 227 prospectively enrolled preterm infants born at <32 weeks gestational age (GA), plasma CT-proET-1 was measured at birth, day of life (DOL) 2, 3, 6 and 28, and at 36 weeks postmenstrual age (PMA). BPD was defined as mild in infants requiring supplemental oxygen at DOL 28 and moderate/severe in those requiring it at 36 weeks PMA. Results: The predictive ability of CT-proET-1 for any BPD was poor at birth [area under the ROC curve (AUC) 0.654, 95% CI 0.494-0.814], moderate at DOL 2 and 3 (AUC 0.769, 95% CI 0.666-0.872) and excellent at DOL 6 (AUC 0.918, 95% CI 0.840-0.995). Multivariable regression analysis revealed that CT-proET-1 levels at DOL 2, 3, 6 and 28 were strongly related to the duration of oxygen supplementation, independently of GA and the duration of respiratory support. Conclusions: CT-proET-1 is a novel promising biomarker for predicting the development of BPD in preterm infants when measured at the end of the first week of life.

Right ventricular function and vasoactive peptides for early prediction of bronchopulmonary dysplasia

“…The predictive value of CT-proET1 for BPD development was highest on DOL 6. In contrast to our current study, Baumann et al showed a persistent association of CT-proET1 with BPD/death even after correction for clinical factors [ 16 ].…”

“…In multivariable logistic regression analysis of our results with birth weight, RIMP, TAPSE, MR-proANP and CT-proET1 in the equation, only birth weight and RIMP remained independent predictors of BPD/death. In a previous study of our group including 227 preterm infants, plasma CT-proET1 was measured at birth, DOL 2, 3, 6, and 28 [ 16 ]. The predictive value of CT-proET1 for BPD development was highest on DOL 6.…”

“…The vasoactive peptides endothelin-1 and natriuretic peptide are associated with pulmonary hypertension in adults [14]. They have previously been also studied in preterm infants and are considered candidate biomarkers for early determination of the BPD risk [15][16][17][18]. However, both echocardiographic indices and vasoactive peptides have not yet been investigated simultaneously in the first week of life in preterm infants so it is unknown which single marker or combination of markers is the best to predict BPD.…”

Endothelin 1 as a predictor marker for bronchopulmonary dysplasia in preterm neonates with respiratory distress syndrome

“…In a recent study, they found that the predictive ability of plasma proendothelin was moderate at days 2 and 3 of life but was excellent at day 6 of life; the area under ROC curve was 0.918 [21].…”

Hyperoxia-induced lung structure–function relation, vessel rarefaction, and cardiac hypertrophy in an infant rat model

“…6b). Baumann et al [39] found a significant difference in a precursor of ET-1 in BPD-affected children until 28 days of age only. However, this difference vanished at 36 weeks postmenstrual age.…”