Abstract
We have studied activation of circulating polymorphonuclear leukocytes(PMN) in plasma of preterm infants with severe idiopathic respiratory distress syndrome (IRDS group, n = 15) and without IRDS (reference group,n = 15) during the first 5 postnatal days. We have observed lower median PMN counts in the IRDS group than in the reference group from d 2 (1.4× 109/L versus 4.8 × 109/L in the reference group, p < 0.001) to d 4 to 6 (1.6 × 109/Lversus 4.0 × 109/L, p < 0.01). Lower PMN counts in the IRDS infants were accompanied by lower median plasma elastase-α1-proteinase inhibitor (PI) concentrations (53.6 ng/mLversus 128.0 ng/mL in the reference group on d 2, p < 0.05). Simultaneously, median elastase-α1-PI/PMN ratios of these infants were significantly higher (40.8 ng/106 PMN versus 21.8 ng/106 PMN on d 2, p < 0.05), indicating activation of circulating PMN. Activation of circulating PMN in the IRDS group is associated with platelet-activating factor (PAF) release and complement activation from within 6 to 12 h of birth but not with release of tumor necrosis factor-α. PAF release was represented by significantly reduced inhibiting capacity (58% of normal human plasma, p < 0.01) and complement activation by higher median plasma C3a des-Arg concentrations (1680 ng/mL versus 325 ng/mL in the reference group, p < 0.001). We conclude that circulating PMN are activated in preterm infants with severe IRDS, which might be caused by systemic PAF release and complement activation. This activation process may play a role in the pathogenesis of the IRDS by influx of activated PMN into the lungs.
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Abbreviations
- IRDS:
-
idiopathic respiratory distress syndrome
- BPD:
-
bronchopulmonary dysplasia
- ARDS:
-
adult respiratory distress syndrome
- PMN:
-
polymorphonuclear leukocytes
- α1-PI:
-
α1-proteinase inhibitor
- TNF-α:
-
tumor necrosis factor α
- PAF:
-
platelet-activating factor
- IC:
-
inhibiting capacity of plasma
- Fio2:
-
fractional concentration of inspired O2
- HELLP:
-
hemolysis, elevated liver enzymes, and low platelet count syndrome
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The authors thank Johan Haan for his technical assistance and Annalie van der Vijver, M.D., for correction of the manuscript.
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Brus, F., Van Oeveren, W., Okken, A. et al. Activation of Circulating Polymorphonuclear Leukocytes in Preterm Infants with Severe Idiopathic Respiratory Distress Syndrome. Pediatr Res 39, 456–463 (1996). https://doi.org/10.1203/00006450-199603000-00013
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DOI: https://doi.org/10.1203/00006450-199603000-00013
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