ROLE OF PLATELET ACTIVATING FACTOR AND TUMOR NECROSIS FACTOR-ALPHA IN NEONATAL NECROTIZING ENTEROCOLITIS

Because previous investigations have suggested that platelet activating factor and tumor necrosis factor-alpha (TNF-α) are important mediators of experimental necrotizing enterocolitis in the rat, we measured platelet activating factor, acetylhydrolase (the platelet activating factor breakdown enzyme), and TNF-α in the plasma of 12 human neonates with necrotizing enterocolitis and eight age-matched control subjects with similar gestational ages, postnatal ages, and weights. Almost all patients with necrotizing enterocolitis had elevated plasma platelet activating factor values (18.1±3.6 ng/ml vs 3.1±0.9 ng/ml in control subjects, p<0.01). Plasma acetylhydrolase activity was lower in patients than in control subjects (10.6±0.7 nmol/ml/min vs 23.0±1.4 nmol/ml/min, p<0.01). Plasma TNF-α concentration was significantly elevated in patients with necrotizing enterocolitis (136±75U/ml vs 1.5±0.8U/ml, p<0.05), although the individual variation was high. There was no correlation between individual. TNF-α and platelet activating factor levels. We conclude that platelet activating factor and TNF-α are elevated in patients with necrotizing enterocolitis and that suppressed platelet activating factor degradation contributes to the increased platelet activating factor levels; platelet activating factor and TNF-α may contribute to the pathophysiology of necrotizing enterocolitis. © 1990 Mosby-year Book, Inc.