Evaluation of cachectin level in preterm neonates as an indicator of necrotizing enterocolitis

Abstract

Background: Necrotizing enterocolitis (NEC) is an inflammatory disorder that affects the gastrointestinal system of the preterm infants (gestational age less than 37 weeks). Cachectin is a cell signaling protein (cytokine) involved in systemic inflammation and is one of the cytokines that make up the acute phase reaction. Aim: To evaluate the level of blood cachectin (TNF-α) in preterm neonates as an indicator for NEC. Material and Methods: The present study was designed as an analytical cross-sectional study that included two groups: i) preterm neonates with necrotizing enterocolitis (NEC) admitted at neonatal intensive care unit (NICU) in Suez Canal University Hospital (n = 25), and ii) healthy preterm neonates (n = 25) who served as a normal control group. All neonates subjected to prenatal, natal and postnatal history, Physical examination, and blood samples were taken from cases once diagnosed as suspected NEC, proven NEC, or advanced NEC and from healthy preterm neonates when taking full oral feeding as a control. Then, measurement of cachectin level was done by ELISA kits. Results: It was found that neonates with necrotizing enterocolitis had significantly higher cachectin level (365.91 ± 260.76 ng/L) than healthy controls (83.92 ± 44.01 ng/L) (P < 0.001) and was also found that cachectin (TNF-α) levels are higher in NEC patients with complications. It was also found that cachectin (TNF-α) level of 116.6 was the best cut-off points with sensitivity of 92% and specificity of 90% for prediction of NEC among preterm neonates. Conclusion: The level of serum cachectin is higher in neonates with NEC than in healthy preterm neonates and it can be used as an indicator for early diagnosis of NEC.