Lukas Wisgrill1, Anja Weinhandl2, Lukas Unterasinger1, Gabriele Amann3, Rudolf Oehler4, Martin L Metzelder2, Angelika Berger1, Thomas M Benkoe5. 1. Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care & Neuropediatrics, Medical University of Vienna, Vienna, Austria. 2. Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria. 3. Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria. 4. Surgical Research Laboratories, Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 5. Department of Pediatric Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: thomas.benkoe@meduniwien.ac.at.
Abstract
BACKGROUND: Symptoms at suspicion of necrotizing enterocolitis (NEC) are often nonspecific and several biomarkers have been evaluated for their discriminative power to both diagnose and predict the course from NEC suspicion to complicated disease requiring surgical intervention. Thus, we aimed to assess the utility of interleukin-6 (IL-6) to predict surgical intervention in infants suffering from NEC and, furthermore, to discriminate infants with starting NEC or late-onset sepsis (LOS). METHODS: IL-6 serum levels at disease onset were retrospectively analyzed in 24 infants suffering from NEC as well as 16 neonates with LOS. RESULTS: IL-6 serum levels at disease onset were significantly higher in infants suffering from NEC necessitating surgical intervention in the disease course compared to infants with medical NEC (5000 [785-5000] vs. 370 [78-4716] pg/ml, p = 0.0008) as well as gram-positive LOS (5000 [785-5000] vs. 84 [12-269] pg/ml, p = 0.0001). Infants suffering from gram-negative LOS exhibited elevated IL-6 serum levels at disease onset comparable to infants with surgical NEC (5000 [1919-5000] vs. 5000 [785-5000] pg/ml, p = 1.00). CONCLUSION: The proinflammatory cytokine IL-6 appears to be a promising marker to distinguish surgical NEC from medical NEC at the onset of disease but cannot discriminate between surgical NEC and gram-negative LOS. LEVEL OF EVIDENCE: II.
BACKGROUND: Symptoms at suspicion of necrotizing enterocolitis (NEC) are often nonspecific and several biomarkers have been evaluated for their discriminative power to both diagnose and predict the course from NEC suspicion to complicated disease requiring surgical intervention. Thus, we aimed to assess the utility of interleukin-6 (IL-6) to predict surgical intervention in infants suffering from NEC and, furthermore, to discriminate infants with starting NEC or late-onset sepsis (LOS). METHODS:IL-6 serum levels at disease onset were retrospectively analyzed in 24 infants suffering from NEC as well as 16 neonates with LOS. RESULTS:IL-6 serum levels at disease onset were significantly higher in infants suffering from NEC necessitating surgical intervention in the disease course compared to infants with medical NEC (5000 [785-5000] vs. 370 [78-4716] pg/ml, p = 0.0008) as well as gram-positive LOS (5000 [785-5000] vs. 84 [12-269] pg/ml, p = 0.0001). Infants suffering from gram-negative LOS exhibited elevated IL-6 serum levels at disease onset comparable to infants with surgical NEC (5000 [1919-5000] vs. 5000 [785-5000] pg/ml, p = 1.00). CONCLUSION: The proinflammatory cytokine IL-6 appears to be a promising marker to distinguish surgical NEC from medical NEC at the onset of disease but cannot discriminate between surgical NEC and gram-negative LOS. LEVEL OF EVIDENCE: II.
Authors: Brian D Hosfield; Chelsea E Hunter; Hongge Li; Natalie A Drucker; Anthony R Pecoraro; Krishna Manohar; W Christopher Shelley; Troy A Markel Journal: Am J Physiol Regul Integr Comp Physiol Date: 2022-08-01 Impact factor: 3.210