Variations in Neutrophil Count in Preterm Infants With Respiratory Distress Syndrome Who Subsequently Developed Chronic Lung Disease

Kohelet, David; Arbel, Eliana; Ballin, Ami; Goldberg, Michael D.

doi:10.1055/s-2000-9279

Cited by 4 publications

(8 citation statements)

References 11 publications

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“…Absolute neutrophil counts were significantly higher in BPD infants compared to non-BPD infants consistent with the previous observations in the first five days of life. 35 However, there was no simple relationship between the increasing ANC and AMC in BPD infants over the course of study and decreased surface adhesion molecules (CD18 and CD62L), which might reflect alteration in haematopoiesis or production of immature cells.…”

Section: Discussionmentioning

confidence: 88%

Neutrophil and monocyte adhesion molecules in bronchopulmonary dysplasia, and effects of corticosteroids

Ballabh

Simm

Kumari³

et al. 2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Aims: To study a longitudinal change in the expression of adhesion molecules CD11b, CD18, and CD62L on neutrophils and monocytes in very low birth weight babies who develop respiratory distress syndrome, to compare these levels between bronchopulmonary dysplasia (BPD) and non-BPD infants, and to assess the effect of corticosteroid treatment on these adhesion molecules. Methods: Of 40 eligible neonates, 11 neonates were oxygen dependent at 36 weeks (BPD 36 weeks), 16 infants were oxygen dependent at 28 days, but not at 36 weeks (BPD d28), and 13 infants did not develop BPD. Seventeen neonates received a six day course of steroid treatment. Expression of CD11b, CD18, and CD62L was measured on neutrophils and monocytes in arterial blood on days 1, 3, 7, 14, 21, and 28, and before and 2-3 days after initiation of dexamethasone treatment by flow cytometry. Results: CD18 expression on neutrophils and monocytes and CD62L on neutrophils, measured as mean fluorescent intensity, was significantly decreased in BPD neonates compared to non-BPD neonates on days 1-28. Dexamethasone treatment significantly decreased CD11b, CD18, and CD62L expression on neutrophils, and CD11b and CD18L expression on monocytes. Conclusions: Decreased CD18 expression on neutrophils and monocytes, and decreased CD62L expression on neutrophils, measured as mean fluorescent intensity during the first four weeks of life in micropremies may be risk factors and early predictors of BPD. Dexamethasone use was associated with decreased expression of CD11b, CD18, and CD62L.

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Section: Discussionmentioning

confidence: 88%

Neutrophil and monocyte adhesion molecules in bronchopulmonary dysplasia, and effects of corticosteroids

Ballabh

Simm

Kumari³

et al. 2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…53,54 In this study, the LR and no-LR groups had similar exposure to ANS and exhibited a similar pattern of ANC changes, with the peak values occurring around the second week of life, which is beyond the theoretical range of ANS effect as observed in previous clinical studies. 51,52 Therefore, the contribution of ANS to the occurrence of LR is limited, if any. The lack of association between ANS and LR in the current observation provided added evidence to the kinetic study by Calhoun et al, 10 which concluded that the responsible mechanism for LR is increased neutrophil production rather than corticosteroid-induced leukocytosis.…”

Section: Discussionmentioning

confidence: 99%

“…48 Large numbers of inflammatory cells, predominantly neutrophils, were found in the bronchoalveolar specimens of preterm infants in various stages of developing BPD shortly after the initiation of mechanical ventilation. [49][50][51][52] The Numbers represent n (%) unless otherwise specified; the 2 groups were compared by using the Student's t, Mann-Whitney rank-sum, and 2 tests.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Extremely Low Birth Weight Infants With Leukemoid Reaction

Hsiao¹

2005

Pediatrics

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ABSTRACT. Background. Leukemoid reaction (LR) is defined as an absolute neutrophil count (ANC) of >30 ؋ 10 3 /mm 3 . No previous study has systemically examined the clinical and prognostic significance of this phenomenon in extremely low birth weight (ELBW) infants.Objective. The purpose of this study was to examine the effect of LR in morbidity, mortality, and long-term developmental outcome in ELBW infants.Method. Infants with gestational age of <30 weeks and birth weight <1000 g were included in the study (n ‫؍‬ 152). The medical records were reviewed for the clinical characteristics and long-term developmental outcome of these infants. Serial complete blood cell count and ANC were calculated on day 1 and weekly thereafter until discharge. LR was defined as an ANC of >30 ؋ 10 3 /mm 3 .Results. LR was detected in 17% of the study infants (26 of 152). ANC increased postnatally in LR (n ‫؍‬ 26) and no-LR (n ‫؍‬ 126) infants during hospitalization, peaked in the second week of life (43 ؎ 3 vs 14 ؎ 1 ؋ 10 3 /mm 3 ), and remained significantly higher in LR infants during the first 5 weeks of life. LR occurred more frequently during the first 2 weeks of life and lasted for 3 ؎ 1 days. There was no significant difference between the LR and no-LR infants in gestational age, birth weight, delivery mode, gender, Apgar scores, or incidence of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, and retinopathy of prematurity. LR infants required a significantly longer duration of ventilatory support (36 ؎ 4 vs 21 ؎ 2 days), longer duration of oxygen requirement (58 ؎ 6 vs 40 ؎ 3 days), and had a higher incidence of bronchopulmonary dysplasia (BPD) (54% vs 25%) compared with no-LR infants. Furthermore, the length of hospitalization was significantly longer in LR infants (69 ؎ 6 vs 54 ؎ 3 days). There was no significant difference between the groups in developmental outcome at 2 years of age including receptive/expressive language, fine/gross motor skills, and hearing. Incidence of abnormal neurodevelopment outcome was also similar between LR and no-LR infants.Conclusions. LR in ELBW infants is associated with a prolonged need for ventilatory and oxygen support, a higher incidence of BPD, and a tendency for lower mortality. The findings from our study suggest that LR is associated with conditions known to have an excess of proinflammatory cytokines. Additional prospective study is needed to understand the relationship between LR, proinflammatory cytokines, and development of BPD. Pediatrics 2005;116:e43-e51. URL: www.pediatrics.org/ cgi/doi/10.1542/peds.2004-1379; leukemoid reaction, absolute neutrophil count, extremely low birth weight infants, bronchopulmonary dysplasia.

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“…Complex mechanisms regulate migration and sequestration of neutrophils in the lungs, and peripheral neutrophil counts are reflective of the severity of neonatal lung disease and its course. 5 A plausible explanation may lie in the phenomenon of priming, a state of enhanced responsiveness of neutrophils, induced by microorganisms, pro-inflammatory cytokines and other bioactive agents aspirated during fetal breathing, including platelet-activating factor, interleukin-6, interleukin-2, and granulocyte-colony stimulating factor (G-CSF). 6,7 G-CSF is a physiological hematopoietic growth factor which selec-tively promotes proliferation, differentiation, and maturation of neutrophils, and it is known to play an important role in pulmonary homeostasis and disease.…”

Section: Introductionmentioning

confidence: 99%

“…Monocytes and macrophages appear to be the primary source of G-CSF production in vivo 11 ; interleukin-1␣, interleukin-1␤, bacterial lipopolisaccaride, and other inflammatory mediators are capable of initiating G-CSF production by monocytes and macrophages 12-14. Unprimed neutrophils can migrate through the lung without causing damage, whereas primed neutrophils are sequestered and inflict damage to lung tissue by virtue of releasing toxic mediators and down-regulating the mature surfactant system. 5 In neonates, especially preterm, cytokine networks and cascade-activation of pro-inflammatory and anti-inflammatory cytokines may not have reached the highest degree of specificity and interregulation. 4 This immaturity, which may provoke pathological changes during infection or inflammation and may lead to severe and chronic neonatal diseases, is under intense investigation.…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Neonatal Leukemoid Reaction and Bronchopulmonary Dysplasia in Low-Birth-Weight Infants: A Cross-Sectional Study

Zanardo¹,

Savio²,

Giacomin³

et al. 2002

Am J Perinatol

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Leukemoid reaction in low-birth-weight (LBW) infants is a rare, recently documented phenomenon, implicated in the sequence of multiorgan inflammatory diseases of preterm infants. The aim of the present paper is to establish whether a neonatal leukemoid reaction is related to bronchopulmonary dysplasia (BPD) development in LBW infants. The design was a case-controlled, retrospective study of all premature infants (born 40,000/mm 3. The relation between BPD occurrence and WBC counts was studied by Bayesian analysis, dividing WBC counts in 5 progressive bands of 10,000 WBC/mm 3, starting from <10,000 to >40,000/mm 3. Five of 50 BPD infants studied demonstrated WBC counts >40,000/mm 3, with an incidence of 10%, while no control preterm infants presented neonatal leukemoid reaction; the estimated number difference is statistically significant ( p <0.001). There was no other significant association demonstrated between maternal or neonatal variables and leukemoid reaction, including chorioamnionitis, sepsis, and the use of antenatal steroids. Our findings provide further data for the identification of prematures exposed to pro-inflammatory cytokines in utero; the injury responsible for BPD in a subset of prematures may begin with a transient leukemoid reaction.

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Variations in Neutrophil Count in Preterm Infants With Respiratory Distress Syndrome Who Subsequently Developed Chronic Lung Disease

Cited by 4 publications

References 11 publications

Neutrophil and monocyte adhesion molecules in bronchopulmonary dysplasia, and effects of corticosteroids

Neutrophil and monocyte adhesion molecules in bronchopulmonary dysplasia, and effects of corticosteroids

Outcome of Extremely Low Birth Weight Infants With Leukemoid Reaction

Relationship Between Neonatal Leukemoid Reaction and Bronchopulmonary Dysplasia in Low-Birth-Weight Infants: A Cross-Sectional Study

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