Calprotectin in Serially Collected Meconium Portions as a Biomarker for Intrauterine Fetal Environment

Abstract

Objective: Understanding the pathomechanisms underlying high meconium calprotectin concentrations is the key to the potential uses of this parameter for the assessment of the intrauterine environment in which the fetus develops. The aim of this study was to measure calprotectin concentrations in serial meconium portions passed after birth and to calculate the individual variations in the total meconium calprotectin content accumulated during gestation. Methods: Calprotectin concentrations were measured using Calprotectin ELISA kit (Immundiagnostik AG) in all meconium portions (n = 81) from 20 healthy neonates. For each neonate, total meconium calprotectin was calculated, reflecting the sum of calprotectin content in all meconium portions from this neonate. Results: The calprotectin concentration in meconium was (mean ± SD) 286.5 ± 214.6 μg/g (range 34.7-1,067.1). Calprotectin concentrations in the last portions passed were nearly 3-fold higher than in the first portions (p = 0.0004). The total individual calprotectin content of (mean ± SD) 3,668.7 ± 1,819.0 μg (range 1,158.9-8,155.5) was related to the birth weight (r = 0.46, p = 0.042). Conclusions: Wide intra- and interindividual differences in calprotectin concentrations in the meconium may reflect intestinal inflammation associated with the fetal adaptation to life outside the uterus. Calprotectin may serve as a biomarker useful for the identification of endogenous and exogenous factors with impact on the intrauterine environment.

Dynamic Changes of Fecal Calprotectin and Related Clinical Factors in Neonates

“…In our study, the high meconial calprotectin was associated with lower BW and meconium-stained AF when stepwise multivariable linear or nonlinear regression analysis was performed ( Table 2 ). However, it was not correlated with GA ( r = −0.125, P = 0.151), 5′-Apgar score ( r = −0.057, P = 0.513) or postnatal days in the first week ( r = −0.136, P = 0.117) unlike previous studies ( 22 , 23 ). Several kinds of perinatal factors including delivery mode, feeding volume, or general conditions were reported with FC previously; however, the results were inconclusive ( 14 , 17 , 24 ).…”

“…The first FC in this study could reflect meconial calprotectin since it was measured on mean 2.14 ± 1.87 days after birth and preterm and term neonates could pass meconium for about 2.0–7.8 days ( 21 ). Previous studies reported that calprotectin in meconium correlated with GA at birth, BW, and poor 5′-Apgar score and that meconial calprotectin could reflect intrauterine environment, intestinal immaturity, and hypoxic–ischemic damage of the intestinal mucosa ( 22 , 23 ). In our study, the high meconial calprotectin was associated with lower BW and meconium-stained AF when stepwise multivariable linear or nonlinear regression analysis was performed ( Table 2 ).…”

“…In this study, a significant drop of FC was observed after the first week, and the concentration was stable after the second week of life. Resolution of intrauterine distress ( 23 ), maturation of intestinal mucosa ( 22 ), establishment of intestinal microbiota ( 15 ), or change from meconium with diverse cellular or molecular compositions to transitional stool may affect the time trend of FC between the first and second weeks of life.…”

Protein and peptide profiles in neonatal meconium

“…Individual proteins with recognized biological roles and their panels established based on their involvement in the same biochemical processes may be a starting point in the search for novel biomarkers measured in meconium, which would improve both our understanding of the pathophysiology of prenatal disorders and the selection of appropriate postnatal care and treatment. The published studies of certain proteins found in meconium (alpha‐1‐antitrypsin, calprotectin, lactoferrin, polymorphonuclear (PMN)‐elastase, myeloperoxidase and ceruloplasmin) describe their properties and suggest potential uses in the noninvasive laboratory investigations of the intrauterine environment and fetal development …”

Changes in the structural components of the mucous membrane and plasma proteins of small intestine enterocytes in fetuses of cattle

“…Відомо, що під час внутрішньоутробного розвитку моторика травного тракту та секреція його залоз слабко розвинені і регулюються місцевими механізмами (Woods et al, 2018;. Якщо на перших етапах ембріонального розвитку стравохід і тонка кишка мають місця тимчасової закупорки, то надалі травний тракт стає прохідним і має слабкі перистальтичні рухи, чим переміщує у нижні відділи меконій (Lisowska-Myjak et al, 2018). До його вмісту входить секрет шлунку і кишечника, щільні частини, що містяться в навколоплодних водах, епітелій шкіри плода тощо.…”