Plasma sE-selectin in Premature Infants: A Possible Surrogate Marker of Retinopathy of Prematurity

Abstract

PURPOSE. To prospectively study plasma levels of soluble E-selectin (sE-selectin) in premature infants and to identify their relationship to retinopathy of prematurity (ROP) on the background of known clinical risk factors. METHODS. Eighty-five sE-selectin plasma samples from 42 preterm infants born at 23 to 32 weeks of gestational age (GA) were analyzed. Twenty-two of the infants did not have ROP, eight had stage I, seven stage II, and five stage III. Infants having no ROP or stage I were designated as the no-ROP group, and infants with stage II or III formed the ROP group. RESULTS. In ROP infants, sE-selectin levels were significantly increased, with a median plasma level of 74.7 ng/mL (range, 28.5-222.0) compared with that in the no-ROP infants, with a median sE-selectin plasma level of 39.7 ng/mL (range, 11.9-130.0, P = 0.005). Children with ROP were born with lower birth weight and at lower GA. They were ventilated and needed surfactant therapy more often. However, multivariate analysis identified only sE-selectin level and GA as independent predictors. An increase of 10 ng/mL in sE-selectin increased the risk of ROP 1.6-fold. Receiver operating characteristic curve analysis confirmed the clinical usefulness of sE-selectin plasma levels in the prediction of ROP. CONCLUSIONS. Elevated sE-selectin plasma levels are associated with the development of ROP and are an independent risk predictor in addition to other known risk factors. A score based on the infant's GA and sE-selectin plasma concentrations would improve ROP prediction. Plasma concentrations in premature infants should be assessed 2 to 3 weeks after birth.