Systemic Inflammation-Associated Proteins and Retinopathy of Prematurity in Infants Born Before the 28th Week of Gestation

Mari Holm, Tora S Morken, Raina N Fichorova, Deborah K VanderVeen, Elizabeth N Allred, Olaf Dammann, Alan Leviton, ELGAN Study Neonatology and Ophthalmology Committees

Invest Ophthalmol Vis Sci. 2017 Dec 1;58(14):6419-6428.

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To assess association between inflammation-associated proteins & severe ROP

RESULTS/CONCLUSIONS In first 3 weeks, high VEGF-R1, MPO, IL-8, ICAM-1, MMP 9, erythropoietin, TNF-α, BFG factor associated with risk for prethreshold ROP. On day 28, high SAA, MPO, IL-6, TNF-α, TNF-R1/-R2, IL-8, and ICAM-1 associated with increased risk. Top quartile concentrations of TNF-α & IL-6 associated with ↑risks of ROP when levels of neuroprotective proteins & growth factors, including BDNF, IGF1, IGFBP-1, VEGFR-1 and -2, ANG-1 and PlGF, were not in top quartile. In contrast, high NT-4 and BDNF are protective only in infants w/o elevated inflammatory mediators. Systemic inflammation during first postnatal month associated with increased risk of prethreshold ROP. Elevated concentrations of GF, angiogenic proteins, and NT appear to modulate risk, and capable of reducing the risk even in the absence of systemic inflammation.