{
  "abstract": "Introduction Autophagy is a crucial cellular degradation pathway that maintains homeostasis during stress. Preterm infants are exposed to significant oxidative and metabolic stress during the perinatal transition. This study aimed to evaluate the levels of autophagy markers (Beclin-1, LC3B-I and LC3B-II) in the umbilical cord blood of preterm infants and investigate their association with neonatal morbidities and mortality.Material and methods This prospective multicentre cohort study included 60 preterm infants. Umbilical cord blood samples were analysed for Beclin-1, LC3B-I and LC3B-II levels using Western blot. The LC3B-I/LC3B-II ratio was calculated as an indicator of autophagic flux. The relationship between these markers and major neonatal outcomes (respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), haemodynamically significant patent ductus arteriosus (hsPDA), early neonatal sepsis (ENS) and mortality) was evaluated using Mann-Whitney U tests and multivariable logistic regression adjusted for gestational age.Results A significant positive correlation was observed between gestational age and Beclin-1 levels (r=0.406, p=0.005). In subgroup analyses, non-survivors exhibited significantly lower median Beclin-1 levels (0.45 vs 0.92, p=0.047) and a depressed LC3B-I/LC3B-II ratio (0.48 vs 1.90, p=0.018) compared with survivors. Similarly, infants with IVH had significantly lower LC3B-I levels (0.07 vs 0.65, p=0.011). However, in multivariable logistic regression analyses adjusted for gestational age, the independent statistical significance of these markers was attenuated, suggesting that the observed autophagic impairment is closely linked to gestational immaturity. No significant associations were found for RDS, hsPDA or ENS.Discussion This study identifies lower cord blood Beclin-1 levels and an altered LC3B ratio as potential markers of vulnerability in preterm infants, particularly for mortality and IVH. The findings suggest that autophagic capacity at birth is developmentally regulated, with more immature infants displaying compromised autophagy initiation.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Coşkun Armağan"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Can Akyıldız"
    },
    {
      "affiliations": [
        "Department of Pediatric Endocrinology, Ankara Etlik City Hospital, University of Health Sciences, Ankara, Turkey"
      ],
      "name": "Gizem Bakır"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Tuğba Üçüncü Egeli"
    },
    {
      "affiliations": [
        "Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, İzmir, Turkey"
      ],
      "name": "Beyza Türe"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Funda Erdoğan"
    },
    {
      "affiliations": [
        "Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, İzmir, Turkey"
      ],
      "name": "Bora Taştan"
    },
    {
      "affiliations": [
        "Izmir Tepecı̇k Education and Research Hospital, Department of Pediatrics, Division of Neonatology, University of Health Sciences, İzmir, Turkey"
      ],
      "name": "Defne Engür"
    },
    {
      "affiliations": [
        "Çı̇ğlı̇ Education and Research Hospital, Department of Pediatrics, Division of Neonatology, Bakırçay University, İzmir, Turkey"
      ],
      "name": "Özgür Olukman"
    },
    {
      "affiliations": [
        "Izmir Tepecı̇k Education and Research Hospital, Department of Pediatrics, Division of Neonatology, University of Health Sciences, İzmir, Turkey"
      ],
      "name": "Sümer Sütçüoğlu"
    },
    {
      "affiliations": [
        "Izmir Tepecı̇k Education and Research Hospital, Department of Pediatrics, Division of Neonatology, University of Health Sciences, İzmir, Turkey"
      ],
      "name": "Özgün Uygur"
    },
    {
      "affiliations": [
        "Izmir Tepecı̇k Education and Research Hospital, Department of Pediatrics, Division of Neonatology, University of Health Sciences, İzmir, Turkey"
      ],
      "name": "Deniz Gonülal"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Burak Deliloğlu"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Nuray Duman"
    },
    {
      "affiliations": [
        "Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, İzmir, Turkey"
      ],
      "name": "Şermin Genç"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Dokuz Eylül University, İzmir, Turkey"
      ],
      "name": "Hasan Özkan"
    }
  ],
  "title": "Autophagy markers in umbilical cord blood-derived PBMCs and their association with preterm morbidities: a prospective multicenter cohort study",
  "uid": "8dd905b0-7620-50dc-98bb-b9bd6eb3332a"
}