Int Immunopharmacol. 2025 May 26;159:114935. doi: 10.1016/j.intimp.2025.114935. Online ahead of print.
ABSTRACT
BACKGROUND: Necrotizing enterocolitis (NEC) is a severe intestinal disease in neonates. The study aims to identify aquaporin-4 (AQP-4) protein and its autoantibodies as potential biomarkers for early diagnosis of neonatal necrotizing enterocolitis.
METHODS: A prospective cohort study was conducted. Plasma samples from newborns suspected of NEC (n = 75) were collected and divided into the NEC group (n = 30) and the non-NEC group (n = 30) according to the follow-up results for autoimmune microarray analysis. Plasma samples from patients matched for gestational age and weight were selected for an independent validation cohort, including plasma samples from newborns with functional abdominal distension (FAD) (n = 21), preterm infants (PI) (n = 30), and newborns diagnosed with NEC according to Bell criteria (n = 73). Plasma AQP-4 protein and autoantibody (IgG/IgM) levels were detected by ELISA, and the diagnostic performance of AQP-4 protein and autoantibody (IgG/IgM) was evaluated by ROC curve analysis.
RESULTS: Prospective autoantibody microarray analysis revealed a significant increase in AQP-4 autoantibodies in the NEC group. ELISA results confirmed elevated levels of AQP-4 protein and its autoantibodies in the NEC group. The area under the curve (AUC) for AQP-4 autoantibodies in the NEC diagnosis was 0.8999 (NEC I: 0.8571) in the FAD cohort and 0.8537 (NEC I: 0.8032) in the PI cohort. Correspondingly, the AUC for AQP-4 protein was 0.9471 (NEC I: 0.9531) in the FAD cohort and 0.8029 (NEC I: 0.7719) in the PI cohort.
CONCLUSION: Plasma AQP-4 protein and its autoantibodies show high diagnostic value for NEC, offering significant potential for early detection.
PMID:40424658 | DOI:10.1016/j.intimp.2025.114935
