Assessment of Pentraxin 3 Level as a Novel Reliable Biomarker for Early Diagnosis of Pulmonary Arterial Hypertension in Neonates

Abstract

Background: Newborn pulmonary arterial hypertension (PAH) is a serious neonatal disease that even with modern mechanical  ventilation modes has a high mortality rate. Pentraxin 3 (PTX3) is a novel biomarker release from endothelial vascular cells and  macrophages with a crucial role in cell proliferation and angiogenesis regulation. However, in all neonatal intensive care units (NICU)  echocardiography may not always be readily available. So, our work aimed to assess serum level of PTX3 in PAH newborns.

Methods: This  is a case-control study performed on 36 neonates divided into 3 groups; including healthy neonates (group I), congenital heart  disease (CHD) without PAH (group II), and with PAH (group III). This study was carried out at NICU of pediatric department, Faculty of  Medicine, Zagazig University. All neonates were subjected to full clinical examination. Systemic diagnosis of CHD and PAH was made  using echocardiography machine. All participants were referred for measurement of PTX3 Level.

Results: There was no significant  difference among the 3 groups with respect to demographic characteristics; age (P = 0.292), and birth weight (P = 0.345). PTX3 levels in  PAH group were significantly higher than CHD-without PH and healthy groups (8.08 ± 0.69 vs. 5.47 ± 0.98 and 2.71 ± 0.48 ng/mL, P = 0.001,  respectively). No significant correlation was found between PTX3 concentrations and cardiac ejection fractions (EF) between PAH  and CHDwithout PAH (r = 0.232, P = 0.173). However, a significant positive correlation was detected between PTX3 concentrations and  heart rate (r = 0.444, P = 0.007) or respiratory rate (r = 0.658, P = 0.0001) among these two groups.

Conclusions: Serum PTX3 level is  significantly higher in PH neonates, hence it may be regarded as a new adjuvant diagnostic tool for the early assessment of PH in  neonates.