Umbilical cord blood and neonatal endothelin-1 levels in preterm newborns with and without respiratory distress syndrome

Abstract

Increased pulmonary vascular resistance in preterm newborn infants with respiratory distress syndrome is suggested, and endothelin-1 plays an important role in pulmonary vascular reactivity in newborns. We determined umbilical cord blood and neonatal (second sample) levels of endothelin-1 in 18 preterm newborns with respiratory distress syndrome who had no clinical or echocardiographic diagnosis of pulmonary hypertension and 22 without respiratory distress syndrome (gestational ages: 31.4 ± 1.6 and 29.3 ± 2.3 weeks, respectively). Umbilical cord blood and a second blood sample taken 18 to 40 h after birth were used for endothelin-1 determination by enzyme immunoassay. Median umbilical cord blood endothelin-1 levels were similar in both groups (control: 10.9 and respiratory distress syndrome: 11.4 pg/ mL) and were significantly higher than in the second sample (control: 1.7 pg/mL and respiratory distress syndrome: 3.5 pg/mL, P < 0.001 for both groups). Median endothelin-1 levels in the second sample were significantly higher in children with respiratory distress syndrome than in control infants (P < 0.001). There were significant positive correlations between second sample endothelin-1 and Score for Neonatal Acute Physiology and Perinatal Extension II (r = 0.36, P = 0.02), and duration of mechanical ventilation (r = 0.64, P = 0.02). A slower decline of endothelin-1 from birth to 40 h of life was observed in newborns with respiratory distress syndrome when compared to controls. A significant correlation between neonatal endothelin-1 levels and some illness-severity signs suggests that endothelin-1 plays a role in the natural course of respiratory distress syndrome in preterm newborns.

Endothelin-1 andL-Arginine in Preterm Infants with Respiratory Distress

“…27 Higher ET-1 in preterm infants who later developed BPD suggests the early involvement of pulmonary hypertension in the pathogenesis of BPD. 28,29 ET-1 is able to augment the production of oxygen radicals from alveolar macrophages, which subsequently increases alveolar inflammation with a positive feed back to up-regulate ET-1 production until eventually BPD ensues. 30 Early ET-1 assay can estimate the severity of pulmonary vascular hypertension and respiratory inflammation; both components are essential for the development of BPD.…”

“…Previously, when blood samples were obtained 18 to 40 hours after birth, ET-1 concentrations correlated with duration of mechanical ventilation. 28 However, it was hard to interpret whether ET-1 was a marker for the severity of the initial illness that could successfully predict the duration of ventilation or it was released as a result of the pulmonary damage caused by mechanical ventilation. Finally, the expression of ET-1in the immediate postnatal age may reflect the stress experienced by these infants during birth.…”

Role of endothelial nitric oxide synthase and endothelin-1 polymorphism genes with the pathogenesis of intraventricular hemorrhage in preterm infants

“… 28 and Benjamin et al . 29 showed that endothelin -1 level was increased in newborns with respiratory distress syndrome. Mei Mei et al .…”

Serum Endothelin‐1 and Transforming Growth Factor‐β Levels in the Newborns With Respiratory Distress

“…Like our study, Kojima et al [19] found out that plasma ET-1 concentrations in newborns with RDS were higher compared to the newborns with RDS-2. A study of Benjamin et al [20] demonstrated that infants with and without RDS had similar umbilical cord ET-1 concentrations, whereas ET-1 concentrations were higher in RDS than in control newborns 18–40 hours after birth. The increased vascular resistance in RDS may be related to high plasma ET-1 concentrations.…”