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

  • Retinal Disorders
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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.

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Data availability

The datasets used and analyzed in the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank the Division of Statistics in Medical Research Collaborating Center (MRCC) at Seoul National University Bundang Hospital for statistical analysis.

Funding

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (No. 2020R1F1A1048362). The funders had no role in the design of this study, data collection, data analyses, data interpretation, or in the writing of this manuscript.

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Author notes

  1. Jae Shin Song and Se Joon Woo contributed equally to this work and should therefore be regarded as equivalent authors

Authors and Affiliations

  1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

    Jae Shin Song & Se Joon Woo

  2. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Seongnam, 463-707, Kyeonggido, Korea

    Kyo Hoon Park, Eunwook Joo, Eunji Oh & Kyong-No Lee

  3. Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

    Hunmin Kim

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Correspondence to Kyo Hoon Park.

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Ethics approval

The study adhered to the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board of the Ethics Committee of the Seoul National University Bundang Hospital, Seongnamsi, Korea (approval no. B-1006/103–102).

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Written informed consent was obtained from the parents of all infants for use of their biological samples and clinical data for research purposes.

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Song, J.S., Woo, S.J., Park, K.H. et al. Cord blood transforming growth factor-β-induced as predictive biomarker of retinopathy of prematurity in preterm infants. Graefes Arch Clin Exp Ophthalmol 261, 2477–2488 (2023). https://doi.org/10.1007/s00417-023-06056-7

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