title: Tumour necrosis factor in the bronchoalveolar secretions of infants with the respiratory distress syndrome and the effect of dexamethasone treatment.
abstract: BACKGROUND
  Tumour necrosis factor alpha may contribute to the lung damage that occurs in the adult respiratory distress syndrome. Whether it occurs in the lungs of preterm infants with respiratory distress syndrome is unknown.
  
  
  METHODS
  Tumour necrosis factor alpha concentrations in the bronchopulmonary secretions of 28 ventilated preterm infants were determined by the enzyme linked immunosorbent assay.
  
  
  RESULTS
  Concentrations were low in the first three days of life, being undetectable in nine of the 20 infants whose bronchopulmonary secretions were sampled. From day 4 concentrations were increased and detectable in all but two of 14 infants. Similar concentrations were found in samples taken on days 8-20 and 21-40. Greater mean concentrations occurred in those infants requiring oxygen for a long time. In six infants who received dexamethasone treatment for prolonged ventilator dependency treatment was associated with a reduction in tumour necrosis factor alpha concentrations.
  
  
  CONCLUSIONS
  Tumour necrosis factor may contribute to the neonatal respiratory distress syndrome, as suggested for the adult respiratory distress syndrome. The therapeutic effects of dexamethasone treatment in neonatal respiratory distress syndrome may be mediated, at least in part, by reduced production of pulmonary tumour necrosis factor.
authors.affiliation: Academic Department of Child Health, Medical College St Bartholomew's Hospital, London.
authors.forename: S H
authors.initials: SH
authors.lastname: Murch
authors.forename: T T
authors.initials: TT
authors.lastname: MacDonald
authors.forename: C B
authors.initials: CB
authors.lastname: Wood
authors.forename: K L
authors.initials: KL
authors.lastname: Costeloe
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology*; D003907:Dexamethasone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000276:immunology*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D003907:Dexamethasone