25(OH)D3, LTB4, MCP-1, MMP-9 and SAA levels in newborns with neonatal pneumonia and their predictive value for the severity of the disease

OBJECTIVE To investigate serum 25-hydroxy vitamin D3(25(OH)D3), leukotriene B4 (LTB4), monocyte chemokine protein 1 (MCP-1), matrix metalloproteinase 9 (MMP-9) and amyloid protein A (SAA) levels in newborns with neonatal pneumonia and their predictive value for the severity of the disease.

METHODS Eighty-one newborns with neonatal pneumonia admitted to Hainan Modern Women and Children′s Hospital from Nov. 2020 to Nov. 2023 were selected as the study group and divided into the severe (36 cases) and the mild groups (45 cases) according to the severity of the disease, and were divided into the bacterial infection (47 cases) and the non-bacterial infection groups (34 cases) according to the type of infection. Another 83 neonates with healthy physical examination during the same period were selected as the control group. The expression of serum 25(OH)D3, LTB4, MCP-1, MMP-9 and SAA levels in each group were compared. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic values of 25(OH)D3, LTB4, MCP-1, MMP-9 and SAA for neonatal pneumonia.

RESULTS The levels of LTB4, MCP-1, MMP-9 and SAA in the study group were (133.47±44.38) pg/ml, (70.14±23.35) ng/ml, (179.86±59.86) ng/ml and (19.75±6.52) μg/L respectively, higher than those in the control group (P < 0.05), which in the severe group were higher than those in the mild group (P < 0.05), and in the bacterial infection group were higher than those in the non-bacterial infection group (P < 0.05). The 25(OH)D3 in the study group was (14.56±4.32) μg/L lower than that in the control group (P < 0.05), which in the severe group was lower than that in the mild group (P < 0.05), and in the bacterial infection group was lower than that in the non-bacterial infection group (P < 0.05). The area under the curve (AUC) of the combined detection for the diagnosis of neonatal pneumonia by plotting ROC curve was higher than that of each single index (P < 0.05).

CONCLUSIONS After the occurrence of neonatal pneumonia, serum LTB4, MCP-1, MMP-9 and SAA are highly expressed, and 25(OH)D3 is lowly expressed, which is closely related to the severity of the disease and infection type of the newborns. The combined detection of the five indexes is helpful for the diagnosis of neonatal pneumonia.