Stool biomarkers useful for predicting necrotizing enterocolitis in preemies

The level of lipocalin-2 and calprotectin in the stool of premature neonates represents a significant biomarker signature for predicting the development of necrotizing enterocolitis (NEC), as shown in a study.

In the study, researchers collected stool samples from 132 very low birth weight infants. The final analysis included eight infants (~6 percent) who received a stage 3 NEC diagnosis and 14 non-NEC controls. The samples were assayed using ELISA for the quantification of potential biomarkers, namely calprotectin, prostaglandin E2, hemaglobin/haptoglobin complex, lysozyme, osteoprotegerin, and lipocalin-2.

The majority of NEC samples were found to be above the cutoff value established for each marker and at all stages, which indicated that the biomarkers could discriminate premature infants that would develop NEC more than a week in advance.

When samples from NEC patients and non-NEC controls were compared, lipocalin-2 and calprotectin emerged as the two most reliable predictive markers over the 10-day period prior to NEC development. Both biomarkers were significantly increased in stool samples of NEC infants up to 1 week before the diagnosis.

Lipocalin-2 was identified as a new biomarker for predicting NEC development, which, combined with calprotectin, could facilitate the identification of more than half of the cases that would develop NEC in very low birth weight infants.