Cord blood transforming growth factor-β-induced as predictive biomarker of retinopathy of prematurity in preterm infants

Graefes Arch Clin Exp Ophthalmol. 2023 Sep;261(9):2477-2488. doi: 10.1007/s00417-023-06056-7. Epub 2023 Apr 6.

Abstract

Purpose: To determine whether 14 inflammation-, angiogenesis-, and adhesion-related proteins in cord blood (CB), alone or in combination with conventional perinatal factors, could predict retinopathy of prematurity (ROP) in preterm infants.

Methods: Data from 111 preterm infants (born at ≤ 32.0 weeks) were retrospectively reviewed. The levels of endoglin, E-selectin, HSP70, IGFBP-3/4, LBP, lipocaline-2, M-CSFR, MIP-1α, pentraxin 3, P-selectin, TGFBI, TGF-β1, and TNFR2 were assessed in stored CB samples collected at birth using ELISA kits. The primary endpoints included severe ROP (≥ stage 3) and type 1 ROP requiring treatment.

Results: ROP was diagnosed in 29 infants (26.1%), among whom 14 (12.6%) had severe ROP and seven (6.3%) had type 1 ROP. Multivariate logistic regression showed that decreased CB TGFBI levels were significantly associated with severe ROP and type 1 ROP after adjusting for gestational age at birth. Stepwise regression analysis allowed to design prediction models with good accuracy, which comprised low CB TGFBI levels and low birth weight (BW) as predictors for severe ROP (area under the curve [AUC] = 0.888), and low CB endoglin levels and low BW as predictors for type 1 ROP (AUC = 0.950). None of the other CB proteins evaluated were found to be associated with severe ROP or type 1 ROP.

Conclusions: Low CB TGFBI levels are associated with severe ROP and type 1 ROP, independently of gestational age. Moreover, combined predictive models based on CB TGFBI and endoglin levels, along with BW data, may act as good indicators at birth for the neonatal risk of ROP progression.

Keywords: Biomarker; Cord blood; Endoglin; Preterm infants; Retinopathy of prematurity; Transforming growth factor-β-induced.

MeSH terms

  • Biomarkers
  • Birth Weight
  • Endoglin
  • Female
  • Fetal Blood / metabolism
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Pregnancy
  • Retinopathy of Prematurity* / diagnosis
  • Retinopathy of Prematurity* / metabolism
  • Retrospective Studies
  • Risk Factors
  • Transforming Growth Factor beta
  • Transforming Growth Factors

Substances

  • Transforming Growth Factor beta
  • Endoglin
  • Biomarkers
  • Transforming Growth Factors