Early increase of TNFalpha and IL-6 in tracheobronchial aspirate fluid indicator of subsequent chronic lung disease in preterm infants

Abstract

Aim-To investigate if early changes in concentrations of proinflammatory cytokines in tracheobronchial aspirate fluid (TAF) from preterm infants could be used to detect infants at risk of chronic lung disease (CLD) and help in the selection of patients for early steroid treatment. Methods-Twenty eight preterm infants less than 34 weeks of gestation (median 26 weeks) were intubated and daily measurements of TAF concentrations of tumour necrosis factor (TNF ) and the interleukins IL-1 , IL-6, and IL-8 were made, using enzyme immunoassay techniques. Results-Seventeen of the infants developed CLD. The infants who developed CLD had significantly increased concentrations of TNF , IL-1ß, IL-6 on days 2 and 3. TNF , IL-6, and IL-8 concentrations were significantly related to gestational age and duration of supplemental oxygen; TNF , IL-6, and IL-8 concentrations also correlated with length of time on the ventilator. Conclusion-These data indicate that tracheobronchial aspirate fluid cytokine concentrations may be used as a predictor of subsequent CLD and may help select a group of preterm infants at high risk of developing CLD for early treatment. (Arch Dis Child 1997;77:F198-F201)

Angiopoietin 2 concentrations in infants developing bronchopulmonary dysplasia: attenuation by dexamethasone

“…Infants who developed BPD had significantly increased concentrations of soluble intracellular adhesion molecule-1, [19][20][21] tumor necrosis factor-a, 22 interleukin (IL)-1b, 22 28,29 transforming growth factor-b-1, 30 fibroblast growth factor-2 31 and endothelin-1. 24 Others have been unable to confirm IL-1b, IL-6, macrophage inflammatory protein-1-a, -b and endothelin-1 31 in the TA as markers for BPD.…”

“…These include soluble intracellular adhesion molecule-1, IL-1b, IL-6 and IL-8. 17,19,20,[22][23][24][25][26]28 In contrast, conflicting results have been reported for VEGF 31,36 and endothelin-1 24,31 TA values in VPIs at risk of developing BPD. Thus, it is difficult to discern the clinical utility of such measurements of a majority of cytokines unless it has been consistently replicated in disparate populations, using standard definitions and techniques.…”

The TNF−α –308, MCP−1 –2518 and TGF−β1 +915 polymorphisms are not associated with the development of chronic lung disease in very low birth weight infants

“…[1][2][3][4][5][6][7][8] Since inflammation is a fundamental pathologic feature of CLD, the genetic variants of cytokine genes may be good candidates to explain some of the individual variation in the development of this complication. TNF-a is a central mediator in the inflammatory cascade and TA concentrations are elevated in infants who develop CLD.…”

“…Increased concentrations of inflammatory mediators in airway secretions during the first week of life have been associated with the development of CLD in the preterm infant suggesting that inflammation plays a central role in this condition. [1][2][3][4][5][6][7][8] Concentrations of tumor necrosis factor-a (TNF-a), a central mediator in the inflammatory cascade, are elevated during the first week of life in the tracheal aspirates (TA) obtained from infants who subsequently develop CLD. 1,2 The magnitude of TNF-a production may be in part genetically determined.…”

Impact of chorioamnionitis on exhaled nitric oxide and endotracheal aspirate levels of nitrites–nitrates and interleukin‐8 in mechanically ventilated preterm neonates

“…Histologic chorioamnionitis is associated with an increase of IL-8 in endotracheal aspirate fluid along the first day of life (≥ 917 pg/mL) and this cutpoint may be used for diagnosis. 24 Preterm infants suffering from bronchopulmonary dysplasia can present increased levels of tumor necrosis alpha (TNF-alfa), 25 IL-6, 25 IL-8, 26 and IL-10 26 in endotracheal aspirates.…”