Research Article | | Peer-Reviewed

Inflammatory Markers in the Diagnosis of Neonatal Necrotizing Enterocolitis

Received: 5 October 2023    Accepted: 1 November 2023    Published: 9 November 2023
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Abstract

As a serious gastrointestinal disease in newborns, neonatal necrotizing enterocolitis (NEC) is characterized by an acute onset, rapid progression and high mortality. The pathogenesis of NEC is complex, which makes diagnosis difficult. The diagnostic gold standard of NEC occurs via intestinal biopsy, but this is not feasible for practical clinical applications. Therefore, the diagnosis of NEC at this stage mainly depends on clinical symptoms and abdominal X-ray imaging. However, the clinical symptoms of infants with early NEC are not specific and the characteristic manifestations seen on imaging often only appear during a critical state of NEC, which easily leads to misdiagnosis or the delay of treatment. Thus, finding a reliable diagnostic method to achieve early diagnosis and treatment is necessary to improve prognosis. As a simple and feasible new diagnostic method in the clinic, inflammatory markers have broad application prospects. In this paper, the common inflammatory markers for early diagnosis of NEC are reviewed from the aspects of the molecular mechanism, research status, and feasibility of the clinical application, including serum amyloid A, C-reactive protein, procalcitonin, fecal calprotectin, intestinal fatty acid binding protein, and cytosolic β-glucosidase. Studies have shown that inflammatory markers possess clinical potential for the early diagnosis of NEC, showing more advantages than traditional imaging methods. However, at present, the research is still limited to small sample and single-center research studies, and evidence from large sample sizes, multi-center studies, and multi-inflammatory markers will be needed to support by additional studies in the future.

Published in American Journal of Clinical and Experimental Medicine (Volume 11, Issue 5)
DOI 10.11648/j.ajcem.20231105.11
Page(s) 86-91
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neonatal Necrotizing Enterocolitis, Inflammatory Markers, Early Diagnosis, Literature Review

References
[1] Jing W. Research progress in the pathogenesis of neonatal necrotizing enterocolitis. Anhui Medical and Pharmaceutical Journal. 2019; 6 (23): 1074-1077.
[2] Jing Y, Ying L, Li Y. Analysis of clinical features of 78 cases of neonatal necrotizing enterocolitis. Journal of Molecular Diagnosis and therapy. 2022; 14 (2): 309-311.
[3] Lin H, Mao S, Shi L, et al. Clinical characteristic comparison of low birth weight and very low birth weight preterm infants with neonatal necrotizing enterocolitis: a single tertiary center experience from eastern china. Pediatric Surgery International. 2018; 34 (11): 1201-1207.
[4] SiYuan J, WeiLi Y, Shujuan L, et al. Mortality and morbidity in infants <34 weeks' gestation in 25 nicus in china: a prospective cohort study. Frontiers in Pediatrics. 2020; 8 (33).
[5] Eaton S, Rees C M, Hall N J. Current research on the epidemiology, pathogenesis, and management of necrotizing enterocolitis. Neonatology. 2017; 111 (4): 423-430.
[6] Jones I H, Hall N J. Contemporary outcomes for infants with necrotizing enterocolitis: a systematic review. The Journal of Pediatrics. 2020; 220 (86-92.
[7] Bazacliu C, Neu J. Necrotizing enterocolitis: long term complications. Current Pediatric Reviews. 2019; 15 (2): 115-124.
[8] Qu J, Lu X, Liu Y, et al. Evaluation of procalcitonin, c-reactive protein, interleukin-6 and serum amyloid a as diagnostic biomarkers of bacterial infection in febrile patients. The Indian Journal of Medical Research. 2015; 141 (3): 315-321.
[9] Yuan W, Dan C, Jian S, et al. Meta analysis of the diagnostic value of serum amyloid a in patients with acute exacerbation of chronic obstructive pulmonary disease. Infection, Inflammation, Repair. 2022; 23 (2): 94-98.
[10] JianSheng Y, Nian Z, Tian C, et al. correlation between serum amyloid a, vascular endothelial growth factor and rheumtoid arthritis. Journal of Hebei Medical University. 2022; 43 (02): 213-217.
[11] ZhenYa L, HuiMin Z, LinYan W. Advances on the correlation between serum amyloid a and cancer diagnosis, stage and prognosis. Journal of Modern Laboratory Medicine. 2023; 38 (03): 207-212.
[12] YunHua L. Value of serum amyloid a and c-reactive protein in diagnosis of infectious diseases in children. Fertility and Health. 2023; 29 (10): 106-108.
[13] Xin L, Qun W, XuWei T, et al. The relationship between serum saa, crp and sirt1 levels and the progression of neonatal necrotizing enterocolitis and their diagnostic value analysis. Progress in Modern Biomedicine. 2021; 21 (10): 1849-1853.
[14] Hua Z, JunTao B, QingLei M, et al. Changes in serum amyloid a and c-reactive protein levels in neonates with necrotizing enterocolitis and their clinical significance. Journal of Medical Forum. 2021; 42 (07): 69-74.
[15] ZeBing Z, YuanMei L, Fan Z, et al. Applicable value of operative opportunity for procalcitonin, interleukin-6 and c-reactive protein in neonatal necrotizing enterocolitis. Journal of Clinical Pediatric Surgery. 2019; 18 (05): 361-367.
[16] Fei L, Ying L. Expression levels of serum creactive protein, procalcitonin, platelet activating factor, intestinal fatty acid binding protein and their conrrelation with prognosis in children with neonatal necrotizing enterocolitis. Shaanxi Medical Journal. 2020; 49 (10): 1228-1231.
[17] JinYu W, MinXia L, DongYun L. Predictive value of c-reactive protein and blood routine changes in the severity diagnosis of neonatal necrotizing enterocolitis. Clinical Medical and Engineering. 2019; 26 (3): 339-340.
[18] YingQi Q. of serum β-glucosidase in diagnosis of neonatal necrotizing enterocolitis. Maternal and Child Health Care of China. 2013; 28 (25): 4256-4258.
[19] Qian W, Kai J, Xi S, et al. Predictive value of serum markers in the operation evaluation of neonatal necrotizing eenterocolitis. Translational Pediatrics. 2023; 12 (5): 897-906.
[20] Lee H. Procalcitonin as a biomarker of infectious diseases. The Korean Journal of Internal Medicine. 2013; 28 (3): 285.
[21] DongXia X, BingXin Y, LiangYong L, et al. Correlation of blood routine, procalcitonin and c-reactive protein with necrotizing enterocolitis in premature infants and its clinical value study. Journal of Qiqihar Medical University. 2017; 38 (12): 1418- 1419.
[22] Yan J, Rong R. Changes of serum intestinal fatty acid binding protein, procalcitonin, c-reactive protein, interleukin-8 levels in neonatal necrotizing enterocol itis and its clinical significance. Hainan Medical Journal. 2021; 32 (06): 763-765.
[23] Lin Lin Y, Lin J, Jing Z, et al. Risk factors of nec and predictive value of serum crp, pct, nlr. Jilin Medical Journal. 2021; 42 (01): 24-27.
[24] Yu Ping Q, Guang Hui L, JueWei Z, et al. The diagnostic value of combined detection of platelet-lymphocyte ratio, serum procalcitonin and amyloid a in neonatal necrotizing enterocolitis. International Journal of Laboratory Medicine. 2022; 43 (21): 2561-2564.
[25] Shu Ting S, Li Ying D. Research progress of fecal biomarkers for early diagnosis of neonatal necrotizing enterocolitis. Medical Recapitulate. 2022; 28 (3): 537-542.
[26] Hui W, ZongTai F, ZuMing Y, et al. Application of fecal calprotectin in the diagnosis of neonatal necrotizing enterocolitis. Hainan Medical Journal. 2018; 29 (17): 2493-2495.
[27] Warapan N, Megan C, David K S, et al. Point-of-care fecal calprotectin monitoring in preterm infants at risk for necrotizing enterocolitis. The Journal of Pediatrics. 2018; 196 (98-103.
[28] MacQueen B C, Christensen R D, Yost C C, et al. Elevated fecal calprotectin levels during necrotizing enterocolitis are associated with activated neutrophils extruding neutrophil extracellular traps. Journal of Perinatology: Official Journal of the California Perinatal Association. 2016; 36 (10): 862-869.
[29] YuFeng L, HaiYing L, WeiGang L, et al. Value of combined tection of serum crp, fc and urine i-fabp in early prediction of nec in premature onfants with intestinal infection. Chinese Journal of Nosocomiology. 2022; 32 (10): 1577-1580.
[30] LingYing H, CunFang B. Value of fc combined with intestinal barrier function in grading diagnosis of neonatal necrotizing enterocolitis. Maternal and Child Health Care of China. 2023; 38 (7): 1242-1245.
[31] YanQiu X, ChangJun R, Xiong W, et al. Role of fecal calprotectin in the diagnosis of neonatal necrotizing enterocolitis: a meta analysis. Chinese Journal of Contemporary Pediatrics. 2021; 23 (4): 381-389.
[32] Anne G J F V, Christian V H, Anneke C M K, et al. Serial fecal calprotectin in the prediction of necrotizing enterocolitis in preterm neonates. Journal of Pediatric Surgery. 2019; 54 (3): 455-459.
[33] XiangJun X, ShuQiang Q. Research progress of biomarkers such as s100a12 protein and vocs in early diagnosis of nec. Chinese Journal of Birth Health and Heredity. 2023; 31 (03): 660-664.
[34] Gisbert J P, McNicholl A G, Gomollon F. Questions and answers on the role of fecal lactoferrin as a biological marker in inflammatory bowel disease. Inflammatory Bowel Diseases. 2009; 15 (11): 1746-1754.
[35] FenFang H, ZhiTao C, Xiang T, et al. Significance of fc in differential diagnosis between ibs and ibd. Sichuan Medical Journal. 2011; 32 (11): 1791-1792.
[36] Zamora I J, Stoll B, Ethun C G, et al. Low abdominal nirs values and elevated plasma intestinal fatty acid-binding protein in a premature piglet model of necrotizing enterocolitis. Plos One. 2015; 10 (6): e125437.
[37] HuiMeng D, Qin L, YuanYuan Z, et al. Expression and clinical significance of i-fabp, gln and cbg in neonatal necrotizing enteritis. The Journal of Medical Theory and Practice. 2022; 20 (35): 3547-3549.
[38] YuXia L, RuiQin Z, Hui Y, et al. Expression and significance of crp, i-fabp and sirt1 in neonatal necrotizing enterocolitis. The Journal of Medical Theory and Practice. 23; 4 (36): 664-666.
[39] Dan L, ZhenLang L, QunYan L, et al. Significance of intestinal fatty acid binding protein combined with platelet count in early diagnosis of nec. Maternal and Child Health Care of China. 2022; 37 (04): 617-620.
[40] Jun X. The application value of serum cbg and s100a12 protein level in clinical stage of neonatal necrotizing enterocolitis. Chinese Journal of Public Health Engineering. 2019; 18 (02): 261-262.
[41] Ling Jing Y, XiaoYu R, BinFeng W. Analysis on the serum markers in early diagnosis of neonatal necrotizing enterocolitis. Maternal and Child Health Care of China. 2020; 35 (23): 4488-4491.
[42] Dan W. The detection serum level of β-glucosidase inneonatal necrotizing enterocolitis and its significance. Chongqing Medicine. 2012; 41 (32): 3410-3411.
[43] XiaoMing W, Ai Ming Z, MingYang Y, et al. Analysis on value of urinary i-fabp combined with cbg in diagnosis of neonatal necrotizing enterocolitis. Chinese Journal of Laboratory Diagnosis. 2021; 25 (06): 853-857.
Cite This Article
  • APA Style

    Chen, Y., Pan, Y., Fan, Q. (2023). Inflammatory Markers in the Diagnosis of Neonatal Necrotizing Enterocolitis. American Journal of Clinical and Experimental Medicine, 11(5), 86-91. https://doi.org/10.11648/j.ajcem.20231105.11

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    ACS Style

    Chen, Y.; Pan, Y.; Fan, Q. Inflammatory Markers in the Diagnosis of Neonatal Necrotizing Enterocolitis. Am. J. Clin. Exp. Med. 2023, 11(5), 86-91. doi: 10.11648/j.ajcem.20231105.11

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    AMA Style

    Chen Y, Pan Y, Fan Q. Inflammatory Markers in the Diagnosis of Neonatal Necrotizing Enterocolitis. Am J Clin Exp Med. 2023;11(5):86-91. doi: 10.11648/j.ajcem.20231105.11

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  • @article{10.11648/j.ajcem.20231105.11,
      author = {Yingying Chen and Yan Pan and Qihong Fan},
      title = {Inflammatory Markers in the Diagnosis of Neonatal Necrotizing Enterocolitis},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {11},
      number = {5},
      pages = {86-91},
      doi = {10.11648/j.ajcem.20231105.11},
      url = {https://doi.org/10.11648/j.ajcem.20231105.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20231105.11},
      abstract = {As a serious gastrointestinal disease in newborns, neonatal necrotizing enterocolitis (NEC) is characterized by an acute onset, rapid progression and high mortality. The pathogenesis of NEC is complex, which makes diagnosis difficult. The diagnostic gold standard of NEC occurs via intestinal biopsy, but this is not feasible for practical clinical applications. Therefore, the diagnosis of NEC at this stage mainly depends on clinical symptoms and abdominal X-ray imaging. However, the clinical symptoms of infants with early NEC are not specific and the characteristic manifestations seen on imaging often only appear during a critical state of NEC, which easily leads to misdiagnosis or the delay of treatment. Thus, finding a reliable diagnostic method to achieve early diagnosis and treatment is necessary to improve prognosis. As a simple and feasible new diagnostic method in the clinic, inflammatory markers have broad application prospects. In this paper, the common inflammatory markers for early diagnosis of NEC are reviewed from the aspects of the molecular mechanism, research status, and feasibility of the clinical application, including serum amyloid A, C-reactive protein, procalcitonin, fecal calprotectin, intestinal fatty acid binding protein, and cytosolic β-glucosidase. Studies have shown that inflammatory markers possess clinical potential for the early diagnosis of NEC, showing more advantages than traditional imaging methods. However, at present, the research is still limited to small sample and single-center research studies, and evidence from large sample sizes, multi-center studies, and multi-inflammatory markers will be needed to support by additional studies in the future.
    },
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Inflammatory Markers in the Diagnosis of Neonatal Necrotizing Enterocolitis
    AU  - Yingying Chen
    AU  - Yan Pan
    AU  - Qihong Fan
    Y1  - 2023/11/09
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    DO  - 10.11648/j.ajcem.20231105.11
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 86
    EP  - 91
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20231105.11
    AB  - As a serious gastrointestinal disease in newborns, neonatal necrotizing enterocolitis (NEC) is characterized by an acute onset, rapid progression and high mortality. The pathogenesis of NEC is complex, which makes diagnosis difficult. The diagnostic gold standard of NEC occurs via intestinal biopsy, but this is not feasible for practical clinical applications. Therefore, the diagnosis of NEC at this stage mainly depends on clinical symptoms and abdominal X-ray imaging. However, the clinical symptoms of infants with early NEC are not specific and the characteristic manifestations seen on imaging often only appear during a critical state of NEC, which easily leads to misdiagnosis or the delay of treatment. Thus, finding a reliable diagnostic method to achieve early diagnosis and treatment is necessary to improve prognosis. As a simple and feasible new diagnostic method in the clinic, inflammatory markers have broad application prospects. In this paper, the common inflammatory markers for early diagnosis of NEC are reviewed from the aspects of the molecular mechanism, research status, and feasibility of the clinical application, including serum amyloid A, C-reactive protein, procalcitonin, fecal calprotectin, intestinal fatty acid binding protein, and cytosolic β-glucosidase. Studies have shown that inflammatory markers possess clinical potential for the early diagnosis of NEC, showing more advantages than traditional imaging methods. However, at present, the research is still limited to small sample and single-center research studies, and evidence from large sample sizes, multi-center studies, and multi-inflammatory markers will be needed to support by additional studies in the future.
    
    VL  - 11
    IS  - 5
    ER  - 

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Author Information
  • Department of Paediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou, China

  • Department of Paediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou, China

  • Department of Paediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou, China

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