Eur J Pediatr Surg 2008; 18(6): 419-422
DOI: 10.1055/s-2008-1038908
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Plasma Soluble E-Selectin in Necrotising Enterocolitis

A. K. Khoo1 , N. J. Hall1 , N. Alexander1 , N. J. Evennett1 , A. Pierro1 , S. Eaton1
  • 1Department of Paediatric Surgery, UCL Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London, UK
Further Information

Publication History

received June 23, 2008

accepted after revision July 7, 2008

Publication Date:
14 November 2008 (online)

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.

References

PhD Simon Eaton

Department of Paediatric Surgery
Institute of Child Health

30, Guilford Street

London WC1N 1EH

UK

Email: s.eaton@ich.ucl.ac.uk