Premium
Novel salivary and genetic biomarkers of risk for NEC or death in premature infants
Author(s) -
Morrow Ardythe Luxion,
Jiang Xi,
MeinzenDerr Jareen,
Huang Pengwei,
Schibler Kurt,
Newburg David,
Warner Barbara
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.lb270
Subject(s) - medicine , saliva , genotype , necrotizing enterocolitis , immunology , phenotype , antibody , gastroenterology , gene , biology , genetics
Objective Necrotizing enterocolitis (NEC) or death often occur in very low birthweight (VLBW, < 1500 g) infants. Intestinal maturation and normal bacterial colonization, which help prevent these outcomes, induce FUT2 ["secretor"] and dampen sialyltransferase gene expression. We tested whether a low secretor, high sialylglycan phenotype predicts risk of NEC or death. Methods Salivary secretor and sialylglycans and FUT2 genotype, indirect measures of intestinal phenotype, were analyzed in 385 VLBW infants. Saliva samples collected on day 9 were analyzed by enzyme immunoassay using monoclonal antibodies. Risk cut‐points were identified by Classification and Regression Tree analysis. NEC was defined as Bell's stage > 2. Results NEC or death occurred in 39 infants. Of infants with low secretor (H‐2), high sialyl (sialyl Lewis a [sLe a ], n=104), 23% developed NEC and 18% died; of those with the reciprocal phenotype (high H‐2/low sLe a , n=73), no NEC or death occurred; risk was intermediate when H‐2 and sLe a were both high or low (p<0.0001; predictive value=0.73). FUT2 genotype was strongly associated with death (13% of non‐secretors [AA], 5% of heterozygotes [AG], 1% of secretor dominant [GG], p=0.001) but not NEC. Conclusions Salivary glycans and FUT2 genotype are associated with risk of NEC and death in VLBW infants, and provide powerful biomarkers for clinical research and practice.