Clinical significance of soluble E-selectin and soluble vascular cell adhesion molecule-1 levels in umbilical cord blood for neonatal respiratory distress syndrome: a retrospective study.
sE-selectin and sVCAM-1 levels in umbilical cord blood are elevated in infants with neonatal respiratory distress syndrome and correlate with disease severity.
Where it sits
this study against the rest of the elamipretide corpusSummary and findings
This study evaluated soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule-1 (sVCAM-1) levels in umbilical cord blood of 558 preterm infants, with 162 in the neonatal respiratory distress syndrome (NRDS) group and 396 in the non-NRDS group. The study found that sE-selectin and sVCAM-1 levels were elevated in NRDS infants and correlated with disease severity. The predictive value for NRDS diagnosis was assessed using ROC curves.
Abstract
<h4>Objective</h4>This study evaluates the clinical significance of soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in umbilical cord blood for neonatal respiratory distress syndrome (NRDS).<h4>Methods</h4>This retrospective single-center study collected 558 preterm infants, categorized into NRDS (<i>n</i> = 162) and non-NRDS (<i>n</i> = 396) groups. sE-selectin and sVCAM-1 levels in umbilical cord blood were measured. Their correlations with the 5-minute Apgar score and PaO<sub>2</sub>/FiO<sub>2</sub> ratio were assessed using Spearman/Pearson analysis. ROC curves were generated to assess their predictive value for NRDS diagnosis and discriminatory value for 28-day prognosis. Logistic and Poisson regression models were used to identify risk factors for poor prognosis.<h4>Results</h4>sE-selectin and sVCAM-1 were elevated in NRDS infants and positively correlated with disease severity. They showed negative correlations with 5-minute Apgar score and PaO<sub>2</sub>/FiO<sub>2</sub> ratio. For NRDS prediction, the AUC was 0.894 for sE-selectin and 0.878 for sVCAM-1. sE-selectin combined with sVCAM-1 achieved an AUC of 0.935. For discriminating poor 28-day prognosis, the AUC was 0.867 for sE-selectin and 0.878 for sVCAM-1. The combined AUC of 0.913 was higher than that of any biomarker alone. sE-selectin (<i>OR</i>: 1.163, 95%CI: 1.057 ∼ 1.279), sVCAM-1 (<i>OR</i>: 1.097, 95%CI: 1.035 ∼ 1.163), and 5-minute Apgar score (<i>OR</i>: 0.408, 95%CI: 0.269 ∼ 0.620) were independently associated with poor prognosis. Poisson regression analysis results in the generalized linear model were consistent with the conclusions of the logistic regression analysis.<h4>Conclusion</h4>sE-selectin and sVCAM-1 are elevated in umbilical cord blood in NRDS infants and closely correlated with disease severity and 28-day prognosis.
Background
This paper addresses the role of soluble E-selectin and soluble vascular cell adhesion molecule-1 in umbilical cord blood as potential biomarkers for neonatal respiratory distress syndrome (NRDS). Prior research has indicated that these molecules may be involved in inflammatory processes related to NRDS. Understanding their levels in preterm infants may provide insights into disease severity and prognosis.
Methods
This retrospective study analyzed 558 preterm infants, with 162 diagnosed with NRDS and 396 without. The levels of sE-selectin and sVCAM-1 were measured in umbilical cord blood. Primary outcome measures included the correlation of these levels with the 5-minute Apgar score and PaO2/FiO2 ratio, assessed using Spearman/Pearson analysis, and the predictive value for NRDS diagnosis and prognosis determined through ROC curves.
Results
The primary endpoint showed that sE-selectin had an AUC of 0.894 for NRDS prediction. Both sE-selectin and sVCAM-1 were elevated in NRDS infants and correlated negatively with the 5-minute Apgar score and PaO2/FiO2 ratio. The combined AUC for sE-selectin and sVCAM-1 was 0.935, indicating a strong predictive capability for NRDS diagnosis.
Interpretation
The findings suggest that sE-selectin and sVCAM-1 may serve as useful biomarkers for NRDS, with AUC values indicating strong predictive ability. However, while these results are statistically significant, the clinical significance of the effect sizes should be evaluated in larger, multi-center studies. The retrospective nature and single-center design may introduce confounding factors that limit the conclusions.
Key findings
- AUC for sE-selectin in NRDS prediction: 0.894.
- AUC for sVCAM-1 in NRDS prediction: 0.878.
- Combined AUC for sE-selectin and sVCAM-1: 0.935.
- AUC for sE-selectin in discriminating poor 28-day prognosis: 0.867.
- AUC for sVCAM-1 in discriminating poor 28-day prognosis: 0.878.
- sE-selectin OR: 1.163 (95% CI: 1.057 ∼ 1.279); sVCAM-1 OR: 1.097 (95% CI: 1.035 ∼ 1.163).
Limitations
- Retrospective study design.
- Single-center study limits generalizability.
- Correlation does not imply causation.
- No long-term follow-up reported.