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Comparative Study
. 2011 May;158(5):745-51.
doi: 10.1016/j.jpeds.2010.10.043. Epub 2011 Jan 22.

Fucosyltransferase 2 non-secretor and low secretor status predicts severe outcomes in premature infants

Ardythe L Morrow  1 , Jareen Meinzen-Derr, Pengwei Huang, Kurt R Schibler, Tanya Cahill, Mehdi Keddache, Suhas G Kallapur, David S Newburg, Meredith Tabangin, Barbara B Warner, Xi Jiang
Affiliations
Comparative Study

Fucosyltransferase 2 non-secretor and low secretor status predicts severe outcomes in premature infants

Ardythe L Morrow et al. J Pediatr. 2011 May.

Abstract

Objective: To investigate secretor gene fucosyltransferase 2 (FUT2) polymorphism and secretor phenotype in relation to outcomes of prematurity.

Study design: Study infants were ≤32 weeks gestational age. Secretor genotype was determined from salivary DNA. Secretor phenotype was measured with H antigen, the carbohydrate produced by secretor gene enzymes, in saliva samples collected on day 9 ± 5. The optimal predictive cutoff point in salivary H values was identified with Classification and Regression Tree analysis. Study outcomes were death, necrotizing enterocolitis (NEC, Bell's stage II/III), and confirmed sepsis.

Results: There were 410 study infants, 26 deaths, 30 cases of NEC, and 96 cases of sepsis. Analyzed by genotype, 13% of 95 infants who were non-secretors, 5% of 203 infants who were heterozygotes, and 2% of 96 infants who were secretor dominant died (P = .01). Analyzed by phenotype, 15% of 135 infants with low secretor phenotype died, compared with 2% of 248 infants with high secretor phenotype (predictive value = 76%, P < .001). Low secretor phenotype was associated (P < .05) with NEC, and non-secretor genotype was associated (P = .05) with gram negative sepsis. Secretor status remained significant after controlling for multiple clinical factors.

Conclusions: Secretor genotype and phenotype may provide strong predictive biomarkers of adverse outcomes in premature infants.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Dot plots of the salivary H optical density (O.D.) values in the 383 study infants with phenotype data by survivorship status, birthweight and gestational age. Genotype is indicated for each infant (black dots represent non-secretor (AA) genotype; red dots – heterozygote secretor (AG) genotype; green dots – homozygote secretor (GG) genotype; and blue dots – unknown genotype). The distribution of H is bimodal in survivors, reflecting the genetic non-secretor and secretor infants. The dotted line indicates the CART cut-point for optimizing differences between groups in death outcome. The number of infants with values above and below the cut-point is indicated for each sub-group. The H antigen O.D. values of non-secretors approach zero, consistent with expectation. The H antigen values of GG secretors is significantly higher (p<0.001, rank sum test) than AG secretors. The H antigen values are significantly lower in deaths than survivors (p<0.001). Differences in salivary H distribution between death and survivor groups are not due to confounding by gestational age or birthweight.
Figure 2
Figure 2
Kaplan-Meier survival curves: Secretor genotype (panel A) and secretor phenotype (panel B) are each significantly associated with risk of death. Non- secretor genotype (AA) was at high risk of death, dominant secretor (GG) was at low risk of death, and risk in heterozygotes (AG) was intermediate (panel A). Secretor phenotype was characterized as low salivary H (high risk of mortality) and high salivary H (low risk of mortality).
See this image and copyright information in PMC

References

    1. Callaghan WM, MacDorman MF, Rasmussen SA, Qin C, Lackritz EM. The contribution of preterm birth to infant mortality rates in the United States. Pediatrics. 2006;118(4):1566–1573. - PubMed
    1. Fanaroff AA, Stoll BJ, Wright LL, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol. 2007;196(2):147, e141–148. - PubMed
    1. Ambalavanan N, Carlo WA, Bobashev G, et al. Prediction of death for extremely low birth weight neonates. Pediatrics. 2005;116(6):1367–1373. - PubMed
    1. Ambalavanan N, Carlo WA, D’Angio CT, et al. Cytokines associated with bronchopulmonary dysplasia or death in extremely low birth weight infants. Pediatrics. 2009;123(4):1132–1141. - PMC - PubMed
    1. Hussain F, Gilshenan K, Gray PH. Does lactate level in the first 12 hours of life predict mortality in extremely premature infants? J Paediatr Child Health. 2009;45(5):263–267. - PubMed

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