Cromolyn sodium prophylaxis inhibits pulmonary proinflammatory cytokines in infants at high risk for bronchopulmonary dysplasia
| Autor: | Andrew B. Campbell, Jeffrey D. Hasday, Rose M. Viscardi, Karl F. Gumpper, Timothy W. Palmer, Vicki Taciak |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Pulmonary and Respiratory Medicine
Neutrophils Cell Count Enzyme-Linked Immunosorbent Assay Critical Care and Intensive Care Medicine Proinflammatory cytokine Double-Blind Method Fibrosis Risk Factors Cromolyn Sodium medicine Humans Prospective Studies Asthma Bronchopulmonary Dysplasia Lung business.industry Tumor Necrosis Factor-alpha Macrophages Respiratory disease Interleukin-8 Infant Newborn medicine.disease medicine.anatomical_structure Bronchopulmonary dysplasia Immunology Cytokines Tumor necrosis factor alpha Inflammation Mediators business Bronchoalveolar Lavage Fluid Interleukin-1 |
| Zdroj: | American journal of respiratory and critical care medicine. 156(5) |
| ISSN: | 1073-449X |
| Popis: | An imbalance of proinflammatory cytokines such as TNF-alpha, IL-1 beta, and the neutrophil chemotactic factor IL-8 and inhibitors (e.g., soluble TNF receptors and IL-1ra) in the lung during the first week of life may contribute to prolonged pulmonary inflammation and fibrosis in bronchopulmonary dysplasia (BPD). Disodium cromoglycate (DSCG) has anti-inflammatory effects in asthma, a disease with many similarities with BPD. In a prospective, randomized, blinded study, we examined whether early DSCG therapy inhibits proinflammatory cytokines in infants at risk for BPD. Twenty-six infants who were identified as high risk (or = 75% probability) for oxygen-dependency at 28 d by a 12-h predictive score and survived 48 h were randomized to nebulized DSCG 20 mg (n = 13) or 2 cc NS (control, n = 13) every 6 h from Day 3 to Day 28. Lung lavage was collected on Day 3 (pre-study) and Day 7 and analyzed for cell count and differential and TNF-alpha, sTNFR1, sTNFR2, IL-1 beta, IL-1ra, and IL-8 concentrations. The groups' pre-study lavage cytokine concentrations were similar, but TNF-alpha and IL-8 concentrations were 3.6- and 4.9-fold lower in the DSCG group on Day 7 compared with levels in the control group. Soluble TNF receptors were unaffected by DSCG. There was a trend towards lower IL-1 beta levels in DSCG-treated infants on Day 7, but IL-1ra levels were unaffected by DSCG therapy. Three control subjects, but no DSCG-treated infants, died during the study period (p = 0.07). There were no significant differences between survivors of the two groups for oxygen-dependency at 28 d (100% control subjects; 85% DSCG). These results suggest that nebulized DSCG may exert an anti-inflammatory effect in the lungs of infantsor = 1,000 g at risk for BPD. |
| Databáze: | OpenAIRE |
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