Neutrophil-Gelatinase-Associated Lipocalin 2, Krebs Von den Lungen-6, Beta 2 Microglobulin, and Adiponectin: Crosstalk in Early Prediction of Bronchopulmonary Dysplasia in Egyptian Preterm

Nema A Soliman Walaa A Keshk

doi:10.4172/2155-9929.1000223

Abstract

Bronchopulmonary dysplasia (BPD) is a respiratory distress syndrome caused by chronic lung parenchymal injury, occurring primarily in preterm infants. Therefore, research for early biomarkers for BPD is really important. This study was conducted to evaluate levels of Krebs Von den Lungen-6 (KL-6) and adiponectin in cord blood, neutrophil-gelatinase-associated lipocalin 2 (NGAL2) mRNA gene expression in broncho-alveolar lavage and urinary beta 2 microglobulin (β2MG) for early prediction of lung injury or possible involvement of those molecules in BPD pathogenesis and development. Method: this study was carried out from September 2012 to December 2013 with 58 preterm neonates of gestational age ≤32 weeks. KL-6, adiponectin and urinary β2MG levels by immunoassay, NGAL2 mRNA level by real-time PCR were determined. Results: cord blood KL-6, urinary β2MG and broncho-alveolar lavage (BAL) fluid NGAL2 mRNA expression levels were significantly increased, while a non-significant decrease in cord blood adiponectin level in BPD preterm relative to preterm without BPD were observed, with the best sensitivity and specificity were for KL-6 and β2MG relative to preterm without BPD. Conclusion: NGAL2, KL-6, and urinary β2MG may have role in early prediction and development of BPD in preterm neonates that may help in early prevention and treatment for better prognosis and outcome.

Highlights

Transition from fetal to postnatal life is one of the most important points in fetal developments especially for preterm and very low birth weight (VLBW) infants [1]
neutrophil-gelatinase-associated lipocalin 2 (NGAL2), Krebs Von den Lungen-6 (KL-6), and urinary β2MG may have role in early prediction and development of Bronchopulmonary dysplasia (BPD) in preterm neonates that may help in early prevention and treatment for better prognosis and outcome
It was found that KL-6 levels were markedly increased in babies with chronic and interstitial lung disease which is characterized by alveolar type 2 pneumocyte hyperplasia with fibrosis which is the characteristic picture of BPD [7]

Summary

Introduction

Transition from fetal to postnatal life is one of the most important points in fetal developments especially for preterm and very low birth weight (VLBW) infants (birth weight, 1500 g) [1]. The hallmark of BPD is a requirement for either oxygen therapy or positive pressure ventilation for 4 or more weeks after birth with chest x-ray findings of persistent hazy opacification or a cyst-like pattern of density [2]. It is a common perinatal complication of preterm infants with a significant risk of long-term disability and morbidity that needs specific markers which aid in accurate prediction of disease development with early prevention, early treatment and better prognosis [3]. It was found that KL-6 levels were markedly increased in babies with chronic and interstitial lung disease which is characterized by alveolar type 2 pneumocyte hyperplasia with fibrosis which is the characteristic picture of BPD [7]

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Results

Conclusion