Abstract
Oxidative injury is implicated in the development of chronic lung disease in preterm infants with respiratory distress. However, direct evidence of a causal role is limited and the source of reactive oxidants has not been identified. We have previously shown that protein carbonyl levels in tracheal aspirates correlate positively with myeloperoxidase, suggesting that neutrophil oxidants could be the source of this protein injury. We have extended these observations by measuring 3-chlorotyrosine, a specific biomarker of the neutrophil oxidant, hypochlorous acid, in tracheal aspirate proteins (144 samples) from 69 infants with birth weight <1500 g. 3-Chlorotyrosine levels were higher in these infants than in larger infants without respiratory distress (median 83 compared with 13 μmol/mol tyrosine). They correlated strongly with myeloperoxidase activity (correlation coefficient 0.75, p < 0.0001) and to a lesser extent with protein carbonyls. 3-Chlorotyrosine levels (at 1 wk after birth) correlated negatively with birth weight or gestational age. They were significantly higher in infants who developed chronic lung disease (oxygen requirement at 36 wk postmenstrual age) than in those who did not (median 88 and 49 μmol/mol tyrosine, respectively) and correlated with days of supplemental oxygen. 3-Chlorotyrosine was also significantly higher in infants who had lung infection or were Ureaplasma urealyticum positive. Our results are the first evidence that chlorinated proteins are produced in the lungs of premature infants and that they are higher in infection. The higher 3-chlorotyrosine levels in infants who develop chronic lung disease suggest that neutrophil oxidants contribute to the pathology of this disease.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- FiO2:
-
fraction of inspired oxygen
- MPO:
-
myeloperoxidase
- TA:
-
tracheal aspirate
- VLBW:
-
very low birth weight
References
Pitkänen OM, Hallman M, Andersson SM 1990 Correlation of free oxygen radical-induced lipid peroxidation with outcome in very low birth weight infants. J Pediatr 116: 760–764
Varsila E, Pitkänen OM, Hallman M, Andersson S 1994 Immaturity-dependent free radical activity in premature infants. Pediatr Res 36: 55–59
Wispe JR, Bell EF, Roberts RJ 1985 Assessment of lipid peroxidation in newborn infants and rabbits by measurements of expired ethane and pentane: influence of parenteral lipid infusion. Pediatr Res 19: 374–379
Buss IH, Darlow BA, Winterbourn CC 2000 Elevated protein carbonyls, lipid peroxidation products and myeloperoxidase in tracheal aspirates from premature infants. Pediatr Res 47: 640–645
Gladstone IM, Levine RL 1994 Oxidation of proteins in neonatal lungs. Pediatrics 93: 764–768
Schock BC, Sweet DG, Halliday HL, Young IS, Ennis M 2001 Oxidative stress in lavage fluid of preterm infants at risk of chronic lung disease. Am J Physiol 281: L1386–L1391
Varsila E, Pesonen E, Andersson A 1995 Early protein oxidation in the neonatal lung is related to development of chronic lung disease. Acta Paediatr 84: 1296–1299
Saugstad OD 2001 Chronic lung disease: oxygen dogma revisited. Acta Paediatr 90: 113–115
Winterbourn CC, Chan TP, Buss IH, Inder TE, Mogridge N, Darlow BA 2000 Protein carbonyls and lipid peroxidation products as oxidation markers in preterm infant plasma: associations with chronic lung disease and retinopathy and effect of selenium supplementation. Pediatr Res 48: 84–90
Zimmerman JJ 1995 Bronchoalveolar inflammatory pathophysiology of bronchopulmonary dysplasia. Clin Perinatol 22: 429–457
Watterberg KL, Demers LM, Scott SM, Murphy S 1996 Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops. Pediatrics 97: 210–215
Speer CP 1999 Inflammatory mechanisms in neonatal chronic lung disease. Eur J Pediatr 158( suppl 1): S18–S22
Groneck P, Gotze-Speer B, Opperman M, Eiffert H, Speer CP 1994 Association of pulmonary inflammation and increased microvascular permeability during the development of bronchopulmonary dysplasia: a sequential analysis of inflammatory mediators in respiratory fluids of high risk preterm neonates. Pediatrics 93: 712–718
De Dooy JJ, Mahieu LM, Van Bever HP 2001 The role of inflammation in the development of chronic lung disease in neonates. Eur J Pediatr 160: 457–463
Merritt TA, Stuard ID, Puccia J, Wood B, Edwards DK, Finkelstein J, Shirpiro DL 1981 Newborn tracheal aspirate cytology: classification during respiratory distress syndrome and bronchopulmonary dysplasia. J Pediatr 98: 949–956
Jackson TC, Chi EY, Wilson CB 1987 Sequence of inflammatory cell migration into lung during recovery from hyaline membrane disease in premature newborn monkeys. Am Rev Respir Dis 135: 937–940
Ogden BE, Murphy SA, Saunders GC, Pathak D, Johnson JD 1984 Neonatal lung neutrophils and elastase/proteinase inhibitor imbalance. Am Rev Respir Dis 130: 817–821
Kettle AJ, Winterbourn CC 1997 Myeloperoxidase: a key regulator of neutrophil oxidant production. Redox Rep 3: 3–15
Pullar JM, Vissers MCM, Winterbourn CC 2000 Living with a killer: the effects of hypochlorous acid on mammalian cells. IUBMB Life 50: 259–266
Winterbourn CC, Kettle AJ 2000 Biomarkers of myeloperoxidase-derived hypochlorous acid. Free Radic Biol Med 29: 403–409
Stadtman ER 1990 Metal ion catalysed oxidation of proteins: biochemical mechanism and biological consequences. Free Radic Biol Med 9: 315–325
Chapman ALP, Senthilmohan R, Winterbourn CC, Kettle AJ 2000 Comparison of mono and dichlorinated tyrosines with carbonyls for detection of hypochlorous acid-modified proteins. Arch Biochem Biophys 377: 95–100
Winterbourn CC, Buss IH 1999 Protein carbonyl measurement by enzyme-linked immunosorbent assay. Methods Enzymol 300: 106–111
Kettle AJ 1996 Neutrophils convert tyrosyl residues in albumin to chlorotyrosine. FEBS Lett 379: 103–106
Hazen SL, Heinecke JW 1997 3-Chlorotyrosine, a specific marker of myeloperoxidase-catalyzed oxidation, is markedly elevated in low density lipoprotein isolated from human atherosclerotic intima. J Clin Invest 99: 2075–2081
Hazen SL, Crowley JR, Mueller DM, Heinecke JW 1997 Mass spectrometric quantification of 3-chlorotyrosine in human tissues with attomole sensitivity: a sensitive and specific marker for myeloperoxidase-catalyzed chlorination at sites of inflammation. Free Radic Biol Med 23: 909–916
Chapman ALP, Hampton MB, Senthilmohan R, Winterbourn CC, Kettle AJ 2002 Chlorination of bacterial and neutrophil proteins during phagocytosis and killing of Staphylococcus aureus. J Biol Chem 277: 9757–9762
Gaut JP, Yeh GC, Tran HD, Byun J, Henderson JP, Richter GM, Brennan ML, Lusis AJ, Belaaouaj A, Hotchkiss RS, Heinecke JW 2001 1966 Neutrophils employ the myeloperoxidase system to generate antimicrobial brominating and chlorinating oxidants during sepsis. Proc Natl Acad Sci U S A 98: 11961–11966
Darlow BA, Winterbourn CC, Inder TE, Graham PJ, Harding JE, Weston PJ, Austin NC, Elder DE, Mogridge N, Buss IH, Sluis KB 2000 The effect of selenium supplementation on outcome in very low birthweight infants: a randomised controlled trial. J Pediatr 136: 473–480
Suresh GK, Davis JM, Soll RF 2001 Superoxide dismutase for preventing chronic lung disease in mechanically ventilated preterm infants. Cochrane Database Syst Rev 1: CD001968
Jankov RP, Negus A, Tanswell AK 2001 Antioxidants as therapy in the newborn: some words of caution. Pediatr Res 50: 681–687
Darlow BA, Sluis KB, Inder TE, Winterbourn CC 1997 Endotracheal suctioning of the neonate: balancing clinical and research needs. Pediatr Pulmonol 23: 217–221
Bozeman PM, Learn DB, Thomas EL 1990 Assay of the human leukocyte enzymes myeloperoxidase and eosinophil peroxidase. J Immunol Methods 126: 125–133
Thomas EL, Jefferson MM, Joyner RE, Cook GS, King CC 1994 Leukocyte myeloperoxidase and salivary lactoperoxidase: identification and quantitation in human mixed saliva. J Dent Res 73: 544–555
Frank L, Sosenko IRS 1987 Development of lung antioxidant enzyme system in late gestation: possible implications for the prematurely born infant. J Pediatr 110: 9–14
Welty SE, Smith CV 2001 Rationale for antioxidant therapy in premature infants to prevent bronchopulmonary dysplasia. Nutr Rev 59: 10–17
Kelly FJ 1993 Free radical disorders of preterm infants. Br Med Bull 49: 668–678
American Academy of Pediatrics and Canadian Paediatric Society 2002 Postnatal corticosteroids to treat or prevent chronic lung disease in preterm infants. Pediatrics 109: 330–338
Vigneswaran R 2000 Infection and preterm birth: evidence of a common causal relationship with bronchopulmonary dysplasia and cerebral palsy. J Paediatr Child Health 36: 293–296
Abele-Horn M, Genzel-Boroviczeny O, Uhlig T, Zimmermann A, Peters J, Scholz M 1998 Ureaplasma urealyticum colonization and bronchopulmonary dysplasia: a comparative prospective multicentre study. Eur J Pediatr 157: 1004–1011
Van Marter LJ, Dammann O, Allred EN, Leviton A, Pagano M, Moore M, Martin C 2002 Chorioamnionitis, mechanical ventilation, and postnatal sepsis as modulators of chronic lung disease in preterm infants. J Pediatr 140: 171–176
Domigan NM, Charlton TS, Duncan MW, Winterbourn CC, Kettle AJ 1995 Chlorination of tyrosyl residues in peptides by myeloperoxidase and human neutrophils. J Biol Chem 270: 16542–16548
Podrez EA, Abu-Soud HM, Hazen SL 2000 Myeloperoxidase-generated oxidants and atherosclerosis. Free Radic Biol Med 28: 1717–1725
Lamb NJ, Gutteridge JM, Baker C, Evans TW, Quinlan GJ 1999 Oxidative damage to proteins of bronchoalveolar lavage fluid in patients with acute respiratory distress syndrome: evidence for neutrophil-mediated hydroxylation, nitration, and chlorination. Crit Care Med 27: 1738–1744
MacPherson JC, Comhair SA, Erzurum SC, Klein DF, Lipscomb MF, Kavuru MS, Samoszuk MK, Hazen SL 2001 Eosinophils are a major source of nitric oxide-derived oxidants in severe asthma: characterization of pathways available to eosinophils for generating reactive nitrogen species. J Immunol 166: 5763–5772
De Andrade JA, Crow JP, Viera L, Bruce AC, Randall YK, McGiffin DC, Zorn GL, Zhu S, Matalon S, Jackson RM 2000 Protein nitration, metabolites of reactive nitrogen species, and inflammation in lung allografts. Am J Respir Crit Care Med 161: 2035–2042
van der Vliet A, Nguyen MN, Shigenaga MK, Eiserich JP, Marelich GP, Cross CE 2000 Myeloperoxidase and protein oxidation in cystic fibrosis. Am J Physiol 279: L537–L546
Gaut JP, Byun J, Tran HD, Heinecke JW 2002 Artifact-free quantification of free 3-chlorotyrosine, 3-bromotyrosine, and 3-nitrotyrosine in human plasma by electron capture-negative chemical ionization gas chromatography mass spectrometry and liquid chromatography-electrospray ionization tandem mass spectrometry. Anal Biochem 300: 252–259
Inder TE, Mocatta T, Darlow BA, Spencer C, Senthilmohan R, Winterbourn CC, Volpe JJ 2002 Elevation of oxidative injury markers in the CNS with periventricular leukomalacia in a premature infant with meningitis. J Pediatr 140: 617–621
Acknowledgements
We thank Dr. Fook-Choe Cheah and Tessa Mocatta for assistance with sample handling and documentation, Melanie Coker for differential peroxidase assays, and the nursing staff in the neonatal intensive care unit of Christchurch Women's Hospital for tirelessly taking samples and organizing delivery to the laboratory.
Author information
Authors and Affiliations
Corresponding author
Additional information
This work was supported by grants from the Health Research Council of New Zealand, New Zealand Lotteries Health Research, and the University of Otago.
Rights and permissions
About this article
Cite this article
Buss, I., Senthilmohan, R., Darlow, B. et al. 3-Chlorotyrosine as a Marker of Protein Damage by Myeloperoxidase in Tracheal Aspirates From Preterm Infants: Association With Adverse Respiratory Outcome. Pediatr Res 53, 455–462 (2003). https://doi.org/10.1203/01.PDR.0000050655.25689.CE
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/01.PDR.0000050655.25689.CE
This article is cited by
-
Discrete interplay of gut microbiota L-tryptophan metabolites in host biology and disease
Molecular and Cellular Biochemistry (2023)
-
Analysis of 19 urinary biomarkers of oxidative stress, nitrative stress, metabolic disorders, and inflammation using liquid chromatography–tandem mass spectrometry
Analytical and Bioanalytical Chemistry (2022)
-
ESR and X-ray Structure Investigations on the Binding and Mechanism of Inhibition of the Native State of Myeloperoxidase with Low Molecular Weight Fragments
Applied Magnetic Resonance (2015)
-
Evaluation and biosynthetic incorporation of chlorotyrosine into recombinant proteins
Biotechnology and Bioprocess Engineering (2012)
-
Myeloperoxidase: a target for new drug development?
British Journal of Pharmacology (2007)