FECAL CALPROTECTIN, PMN-ELASTASE AND ELASTASE-1 AS MARKERS OF ENTERAL DYSFUNCTION IN FULL-TERM NEONATES WITH PERINATAL PATHOLOGY
DOI:
https://doi.org/10.11603/24116-4944.2024.2.15088Keywords:
neonate, perinatal pathology, enteral insufficiency, fecal markers, calprotectin, PMN-elastase, elastase-1Abstract
The aim of the study – to determine dynamic changes in the levels of the fecal markers of enteral dysfunction (calprotectin, PMN-elastase, elastase-1) in full-term neonates with perinatal pathology during early neonatal period.
Materials and Methods. A comprehensive clinical-paraclinical examination of 205 full-term neonates was conducted. 82 of the infants presented the signs of severe perinatal pathology (group I) and 73 infants – moderate perinatal pathology (group II). 50 healthy full-term neonates were in the control group (group III). The study was carried out on the base of the Municipal Non-Profit Institution «Municipal Clinical Maternity Home № 2» of Chernivtsi Municipal Council, and German-Ukrainian laboratory «Bukintermed» (Chernivtsi). The licensed program Statistica (StatSoft Inc., Version 7.0) was used for statistical data analysis. The study was conducted following the «Rules of Ethical Principles of Conducting Scientific Medical Research with Human Participation», approved by the Declaration of Helsinki (1964–2013), ICH GCP (1996), EU Directives No. 609 dated 24.11.1986, the Order of the Ministry of Health of Ukraine No. 690 dated 23.09.2009, and the conclusion of the Biomedical Ethics Board of Bukovinian State Medical University.
Results and Discussion. The studied groups were similar according to their gestational age and anthropometric parameters at birth, and gender characteristics. During the first week of life, the level of calprotectin in infants from group I increased from (162.5±8.1) to (264.17±10.1) mcg/g (р<0.0001), in group II – from (296.2±11.2) to (388.9±12.4) mcg/g (р<0.0001), and in infants from group III it decreased from (423.3±20.06) to (260.1±12.4) mcg/g (р<0.0001). The highest level of this marker in the meconium was found in healthy neonates, while in infants with the signs of moderate perinatal pathology – in feces on the seventh day of their lives.During the first seven days of life, PMN-elastase levels in infants from group I decreased from (345.3±15.8) to (100.9±4.71) ng/g (р<0.0001), in group II – from (300.4±15.0) to (45.5±1.84) ng/g (р<0.0001), and in infants from group III – from (463.3±17.3) to (132.8±6.4) ng/g (р<0.0001). The highest level of this enzyme was found in healthy neonates both in meconium and in feces on the seventh day of their lives. The level of fecal elastase-1 during the early neonatal period in infants from group I increased from (214.7±10.1) to (326.4±15.6) mcg/g (р<0.0001), in group II – from (134.9±6.18) to (221.6±11.0) mcg/g (р<0.0001), and in infants from group III – from (133.4±6.98) to (189.4±9.01) mcg/g (р<0.0001). The highest level of this marker was found in meconium and in feces on the seventh day of lives in infants with severe perinatal pathology.
Conclusions. Results of the study were indicative of a multidirectional dynamics in the levels of enteral dysfunction fecal markers during the early neonatal period in both healthy neonates and infants with different degree of perinatal pathology. The results obtained expand scientific knowledge concerning reference values of these markers in neonates and the role they play in physiological adjustment of the intestines to the conditions of extra-uterine life, as well as in diagnostics of enteral dysfunction with underlying perinatal pathology.
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