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Plasma Soluble E-Selectin in Necrotising Enterocolitis

Khoo, AK; Hall, NJ; Alexander, N; Evennett, NJ; Pierro, A; Eaton, S; (2008) Plasma Soluble E-Selectin in Necrotising Enterocolitis. EUR J PEDIATR SURG , 18 (6) 419 - 422. 10.1055/s-2008-1038908.

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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.

Type: Article
Title: Plasma Soluble E-Selectin in Necrotising Enterocolitis
DOI: 10.1055/s-2008-1038908
Keywords: necrotising enterocolitis, adhesion molecules, E-selectin, inflammation, INFLAMMATORY RESPONSE SYNDROME, C-REACTIVE PROTEIN, ADHESION MOLECULE, NEONATAL SEPSIS, ICAM-1, INFANTS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Development Bio and Cancer Prog
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Developmental Neurosciences Prog
URI: http://discovery.ucl.ac.uk/id/eprint/367163
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