Human Epididymis Protein 4 Levels in Neonates with Respiratory Disorder

Introduction. Transient tachypnea of the newborn (TTN) is one of the most common causes of respiratory distress in the full-term neonates. The diagnosis of TTN in early postnatal period remains problematic for clinicians, and unfortunately, there exist no reliable diagnostic tests for TTN. The elevated human epididymis protein 4 (HE4) levels were observed in the cases of severe bronchitis, pneumonia, and inflammatory processes. However, little is known about the fluctuation of this biomarker concentrations in respiratory disorders in neonatal period. The authors investigated the HE4 levels found in the umbilical cord blood and venous blood samples of the newborns with respiratory disorder (TTN) and blood samples of their mothers. Materials and Methods. The investigated neonates were divided into two groups: 23 neonates with the respiratory insufficiency (transient tachypnea of the newborn, TTN) as the study group and 28 newborns of healthy mothers constituted the control group (CG). The C-reactive protein (CRP) and procalcitonin (PCT) as well as HE4 levels were determined in umbilical cord blood and venous blood for all the examined neonates and their mothers. Results. There were no differences found in the HE4 levels determined for the mothers' blood samples and umbilical cord blood samples in all investigated groups. In comparison with healthy children, the elevated HE4 levels were observed in neonates with TTN. Significant positive correlation between HE4 and CRP as well as PCT levels was observed in all investigated neonates. The receiver operating characteristic (ROC) curve analysis demonstrated the cut-off value for the serum HE4 in the researched neonates at the level of 318.5 pmol/L, yielding the sensitivity of 73.9% and specificity of 66.7% for the early diagnosis of TTN. Conclusions. Serum HE4 could be considered as a candidate biomarker for the early diagnosis of pulmonary dysfunction in the newborns.