01 Oct Allergy Cells Predict Bowel Complications In Preterm Babies
Medical Research: What is the background for this study?
Dr. Sherman: We understand eosinophils are inflammatory cells in the lung during asthma attacks. Publications in a Nature journal described how eosinophils come to the lung after airway injury. Since the lung and intestine have the same embryonic source, we theorized that eosinophils would rise in the blood after the onset of necrotizing enterocolitis in preterm human infants. We correctly predicted that a rise in blood eosinophils would predict later complications from this disease.
Medical Research: What are the main findings?
Dr. Sherman: We found that within two days of disease onset infants could have a rise in eosinophils greater than 5% of the total white blood cell count. If this increase persisted for five or more days, the infant was at risk for later medical or surgical complications including feeding problems, bowel blockage, or intestinal rupture Area under the curve = 0.97, CI: .92-1.0). The babies having this finding were smaller and more premature.
Medical Research: What should clinicians and patients take away from your report?
Dr. Sherman: Pediatricians and neonatologists can easily examine hematologic testing in the week after the onset of necrotizing enterocolitis and predict which infants may have complications. These infants should have heightened surveillance for complications. We described a Lickert scale of complication that were highly predictive of the side effects of necrotizing enterocolitis.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Sherman: Additional biomarkers of the onset of and/or complications of neonatal necrotizing enterocolitis (NEC) are under development by the same investigative team. Adult researchers are evaluating a number of strategies to prevent intestinal fibrosis or scarring in adult Crohn’s disease, a disease with side effects akin to NEC. Those treatment strategies may be useful in alleviating complications in NEC if proven in adult patients.
Lila S. Wahidi, Jan Sherman, Mindy M. Miller, Habib Zaghouani, Michael P. Sherman. Early Persistent Blood Eosinophilia in Necrotizing Enterocolitis Is a Predictor of Late Complications. Neonatology, 2015; 108 (2): 137 DOI: 10.1159/000431305
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Michael P. Sherman, MD, FAAP (2015). Allergy Cells Predict Bowel Complications In Preterm Babies