Relationship between necrotizing enterocolitis with plasma VEGF and other cytokin levels in premature babies

In this study, it was aimed to understand better the necrotizing enterocolitis (NEC) table by investigating the demographic and clinical characteristics and serological markers. In this study, 42 patients who were hospitalized at Fırat University Hospital Newborn Intensive Care Unit, born 32 weeks or less between 1.2.2016 and 1.2.2017, were evaluated prospectively. 24 of the cases were in the NEC group and 18 of them were in the control group. On the postnatal days 1, 7, 14, and 28 of the cases, 0.5 cc of blood was taken from routine blood samples and centrifuged and stored at -80. VEGF-A, VEGFR-2, EPO, HIF-1α, IGF-1 and ANG-2 levels of the serum samples were studied. Groups were compared in terms of demographic, clinical and laboratory characteristics. When we evaluated the NEC stages in the NEC group, 16 patients were stage 1 (66.6%), 8 patients (33.3%) were stage 2-3 patients NEC. Levels of VEGFR-2, EPO and VEGF-A were statistically significantly higher in the control group on days 1 and 7 than both of patient groups, on days 14 and 28 than classical NEC group (p <0.05). ANG-2 levels were found to be statistically significantly higher at 7th day in the early NEC group compared to the other two groups (p <0.05). On the 14th and 28th days, control group levels were found to be statistically significantly lower than the classical NEC group (p <0.05). HIF-1α levels were found to be statistically significantly higher than the other two groups in the early NEC group on the 7th day (p <0.05). On the 14th and 28th days in the classical NEC group, it was found to be statistically significantly higher than the control group (p <0.05). IGF-1 levels were found to be statistically significant at the 7th day in the classical NEC group compared to the early NEC group, but lower at the 14th day (p <0.05). On day 14, the level of the control group was found to be statistically significantly higher than that of the classical NEC group, whereas it was found to be lower at 28 days (p <0.05). In our study, the main pathophysiological phenomenon in the NEC group was thought to be intestinal hypoxia / ischemia and the triggered inflammatory response and intestinal dysmotility. For this reason, a new physiopathological classification, staging and treatment approach was considered necessary for various clinical tables in the NEC spectrum. In addition, the parameters in our study have been promising in the diagnosis and treatment of NEC. There is a need for further study. Key words: NEC, premature, VEGF-A, VEGFR-2