Best Abstract Award 2009

This abstract won the 'Best Abstract Award' for Clinical Sciences during ISCOMS 2009. This is an example of a very well-written abstract.

Abstract written by: Erik Moerch

Titel

Calprotectin and IL-8: markers of intestinal inflammation in (pre)term infants?

Introduction

In newborns, a systemic inflammatory response occurs within 15 minutes after birth. The gastrointestinal tract may also participate in this postnatal inflammatory response. Fecal calprotectin (f-calprotectin) and IL-8 (f-IL8) may reflect this inflammatory response. F-IL8 is a pro-inflammatory cytokine produced by myelomonocytotic cells that precedes f-calprotectin in the inflammatory response. F-IL8 attracts and activates neutrophil granulocytes, macrophages and monocytes. These cells contain f-calprotectin, a calcium-bound soluble protein in their cytosol. We hypothesize that an intestinal inflammatory response, reflected by f-calprotectin and f-IL8, occurs after birth and that this response is more pronounced in preterm than in term infants. In addition, we hypothesize that perinatal factors influence f-calprotectin and f-IL8.
The aim of the study was to compare f-calprotectin and f-IL8 in preterm and term infants, and to determine the influence of perinatal factors on f-calprotectin and f-IL8 in preterm infants.

Methods

In preterm infants (gestational age <32 weeks and/or birth weight <1500 gram) and term infants (gestational age >37 weeks), fecal samples were collected within 48 hours after birth. F-calprotectin was measured by ELISA (Buhlmann, Basel, Switzerland) and f-IL8 by random-access chemiluminescence immunoassay (Siemens, Breda, The Netherlands). Perinatal factors of preterm infants were recorded. Data are expressed as median and range. Data were analysed by Mann-Whitney U test, Spearman correlation and lineair regression after log transformation (SPSS 15.0). A p-value <0.05 was considered statistically significant.

Results

In total 20 term infants (gestational age 39.1 weeks (37-42.3), birth weight 3493 gram (2115-4320) and 121 preterm infants (gestational age 29.9 weeks (25.0-34.7), birth weight 1290 gram (640-2300) were included. F-calprotectin and f-IL8 were both higher in preterm than in term infants (480 vs 190 μg/g, p<0.001 and 42.4 vs 4.9 pg/mL, p<0.001 respectively). F-calprotectin and f-IL8 were strongly correlated (beta=0.45, p<0.001). In preterm infants, Apgar score at 5 min <6 and birth weight were negatively correlated with f-calprotectin (beta=2.3, p=0.02, beta=2.4, p=0.02 respectively). Gestational age was negatively correlated with f-IL8 (beta=2.9, p=0.04). Vaginal delivery, chorioamninitis and perinatal corticosteroids did not correlate with f-calprotectin or f-IL-8)

Conclusion

F-calprotectin and f-IL8 are higher in preterm than in term infants. F-calprotectin and f-IL8 are strongly correlated. Of the perinatal factors in preterm infants, birth weight and Apgar score at 5min <6 influences f-calprotectin and gestational age influences f-IL8. F-calprotectin and f-IL8 may be promising markers of intestinal inflammation in (pre)term infants.

Keywords

Calprotectin, IL-8, gastrointestinal inflammation, infants