Serum levels of platelet-activating factor, platelet-activating factor acetylhydrolase, and tumor necrosis factor-alpha in neonates with necrotizing enterocolitis before and after treatment

ABSTRACT

Because previous investigations have suggested that platelet activating factor, and tumor necrosis factor,-alpha [TNF-alpha] are thought to be important mediators of experimental necrotizing enterocolitis in animals, we measured platelet activating factor [PAF], PAF-acetylhydrolase [PAF-AHs], and TNF-alpha in the serum of 23 human neonates with necrotizing enterocolitis before and 2 weeks after treatment and 14 age-matched control subjects with similar gestational ages, postnatal ages, and weights. Patients included in this study were studied from June 2002 to May 2004 at Neonatal Intensive Care Unit of Tanta University Hospital, Egypt Almost all patients with necrotizing enterocolitis had elevated serum platelet activating factor values [17.9 +/- 4.1 ng/ml vs. 3.7 +/- 0.8 ng/ml in control subjects, p < 0.01]. Serum acetylhydrolase activity was lower in patients than in control subjects [11.2 +/- 0.6 nmol/ml/min vs. 24.9 +/- 2.1 nmol/ml/min, p < 0.01]. Serum TNF-alpha concentration was significantly elevated in patients with necrotizing enterocolitis [119.2 +/- 63.1 U/ml vs. 5.7 +/- 1.7 U/ml, p < 0.01]. There were no significant differences between serum levels of PAF, TNF-alpha, and PAF-AHs between controls and survived patients 2 weeks after treatment, p>0.05. Also there were no significant differences between serum levels of PAF, TNF-alpha and PAF-AHs on admission between dead and survived patients, p>0.05. There was no correlation between individual platelet activating factor levels and both TNF-alpha and PAF-AHs levels in patients. We concluded that platelet activating factor and TNF-alpha are elevated in patients with necrotizing enterocolitis and that reduced platelet activating factor degradation contributes to the increased platelet activating factor levels, which together with TNF-alpha may con tribute to the pathophysiology of necrotizing enterocolitis in human neonates. The use of agents that antagonize or contain degrading factors of PAF might provide therapeutic and/or prophylactic options in the management of NEC