Plasma soluble e-selectin in necrotising enterocolitis

Khoo, A.K., Hall, N.J., Alexander, N., Evennett, N.J., Pierro, A. and Eaton, S. (2008) Plasma soluble e-selectin in necrotising enterocolitis. European Journal of Pediatric Surgery, 18 (6), 419-422. (doi:10.1055/s-2008-1038908). (PMID:19012233)

Abstract

Aim: E-selectin is an important mediator of leukocyte-endothelial adhesion. It is expressed on activated endothelium, and shed into the circulation in its soluble form. In babies with necrotising enterocolitis (NEC), increased intestinal expression of E-selectin has been associated with multiple organ failure and an adverse outcome. The aim of this study was to determine whether increased circulating soluble E-selectin (sE-selectin) was associated with a worse prognosis.

Methods: With ethical approval, plasma samples from 20 infants with Bell stage II and III NEC were analysed. Both pre- and postoperative samples were available in 6 infants. The severity of illness was assessed using a sequential organ failure assessment score (SOFA) specifically designed for use in NEC. Plasma concentration of sE-selectin was determined by ELISA. Data, which were not normally distributed, were compared by Spearman's rank correlation coefficient and Wilcoxon signed rank test.

Results: Plasma sE-selectin was strongly negatively correlated with corrected gestational age at the time of sampling (r?=???0.425, p?=?0.006). There was no association between plasma sE-selectin and outcome (death or survival to discharge), severity of intestinal disease (focal, multifocal or pan-intestinal), or SOFA score. Surgery for suspected perforation, however, caused a significant elevation in sE-selectin levels (p?=?0.031).

Conclusions: Plasma sE-selectin, a described marker of endothelial activation, is increased following surgery for NEC. However, prematurity appears to be the cause of an increase in sE-selectin level, confounding the potential use of sE-selectin levels as a predictor of severity of illness in NEC.

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Contributors

Author: N.J. Hall

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