Abstract
Unresolved pulmonary inflammation in hyaline membrane disease (HMD) may be a precursor to the development of chronic lung disease of early infancy. We investigated whether nuclear factor κB (NF-κB), a transcription factor that regulates the inflammatory process, is activated in pulmonary leukocytes in tracheal aspirates from premature infants with HMD. A total of 172 samples were obtained from 59 infants, two thirds of whom showed NF-κB activation in lung neutrophils and macrophages on at least one occasion. Infants who had activated NF-κB showed elevated tumor necrosis factor-α concentrations in their tracheal aspirates. These infants also required a longer period of mechanical ventilation support. Almost half of the infants with HMD had antenatal exposure to chorioamnionitis on the basis of placental histopathologic examination. These infants had evidence of activated NF-κB and elevated cytokines and were more likely to have Ureaplasma urealyticum colonization in their airways. Together, these observations suggest that NF-κB activation in pulmonary leukocytes may be involved in the lung inflammatory process in infants with HMD.
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Abbreviations
- CLD:
-
chronic lung disease
- DART:
-
Dexamethasone (postnatal) in tiny babies, A Randomised Trial
- Fio2:
-
fractional inspired oxygen
- HMD:
-
hyaline membrane disease
- IκB:
-
inhibitor of κB
- NF-κB:
-
nuclear factor κB
- TNF-α:
-
tumor necrosis factor-α
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Acknowledgements
We gratefully acknowledge the efforts taken by nurses of the neonatal intensive care unit, Christchurch Women's Hospital, to collect the tracheal aspirate samples. We also thank Nina Mogridge and Phil Tough for assistance in managing a clinical database; Tim Chan, Dr. Harold Neal, Dr. Kelly Summers, and Dr. Christine Morris for advice on technical issues; Dr. Laurie Hunter for analyzing the placental histopathologic samples; Trevor Anderson for running the PCR analysis of Ureaplasma urealyticum; Tim Harwood for help in sample processing and data entry; and Dr. Patrick Graham for advice on statistical analyses.
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This research was funded by a project grant from the University of Otago and the Health Research Council of New Zealand. F.-C.C. was holder of the University of Otago 125th Jubilee International Postgraduate Scholarship Award. M.H. holds a Sir Charles Hercus Fellowship from the Health Research Council of New Zealand.
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Cheah, FC., Winterbourn, C., Darlow, B. et al. Nuclear Factor κB Activation in Pulmonary Leukocytes from Infants with Hyaline Membrane Disease: Associations with Chorioamnionitis and Ureaplasma urealyticum Colonization. Pediatr Res 57, 616–623 (2005). https://doi.org/10.1203/01.PDR.0000156209.37627.82
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DOI: https://doi.org/10.1203/01.PDR.0000156209.37627.82
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