Stool biomarkers may help predict necrotizing enterocolitis in preemies: Study

One of the most life-threatening conditions for premature infants in neonatal intensive care units (NICU) is necrotizing enterocolitis (NEC), a gastrointestinal disease associated with severe intestinal inflammation and necrosis, which occurs in 5–16% of very low birth weight (VLBW) infants with a mortality rate of 20–50% and various long-term clinical sequels for the survivors.

There are numerous factors that could be involved in the aetiology and pathogenesis of necrotizing enterocolitis (NEC), but the most consistently reported ones are functional and immune intestinal immaturity and dysbiosis, formula feeding and low birth weight. In this study, stools from 132 very low birth weight infants were collected daily in the context of a multi-centre prospective study aimed at investigating the potential of faecal biomarkers for NEC prediction. Eight infants (~6%) received a stage 3 NEC diagnosis.

Their stools collected up to 10 days before diagnosis were included and matched with 14 non-necrotizing enterocolitis (NEC) controls and tested by ELISA for the quantitation of eight biomarkers.

The results of the study are as follows:

· Biomarkers were evaluated in all available stool samples leading to the identification of lipocalin-2 and calprotectin as the two most reliable predicting markers over the 10-day period prior to necrotizing enterocolitis (NEC) development.

· Pooling the data for each infant confirmed the significance of lipocalin-2 and calprotectin, individually and in combination 1 week in advance of the NEC clinical diagnosis.

The researchers concluded that the lipocalin-2 and calprotectin tandem represent a significant biomarker signature for predicting NEC development. Although not yet fulfilling the "perfect biomarker" criteria, it represents the first step toward it.

Reference:

Lipocalin-2 and calprotectin as stool biomarkers for predicting necrotizing enterocolitis in premature neonates by Thibault M et. al published in the Pediatric Research.

https://doi.org/10.1038/s41390-021-01680-7