Monocyte chemoattractant protein-1 and interleukin-8 are increased in bronchopulmonary dysplasia: relation to isolation of Ureaplasma urealyticum.
BACKGROUND
An exaggerated inflammatory response occurs in infants who subsequently develop bronchopulmonary dysplasia (BPD). Ureaplasma urealyticum (Uu) is frequently isolated from cultures of tracheal secretions obtained from very low birth weight infants and is associated with an increased risk of BPD.


METHODS
We examined the relationships between isolation of genital mycoplasmas, tracheal aspirate (TA) interleukin-8 (IL-8), and monocyte chemoattractant protein-1 (MCP-1) concentrations and the development of BPD. Serial TAs were obtained prospectively from 35 very low birth weight infants, and IL-8 and MCP-1 concentrations were determined by enzyme-linked immunoadsorbent assay. Tracheal cultures for bacteria and genital mycoplasmas were performed on aspirates obtained during the first 2 days of life.


RESULTS
Infants who developed BPD (n=18) were less mature (25.2+/-0.2 vs 27.8+/-0.5 weeks; P<0.001), of lower birth weight (746+/-28 vs 1052+/-41 g; P<0.001), and more likely to have a positive tracheal culture for Uu (39% vs 6%; P=0.026) than those who did not develop BPD (n=17). Tracheal concentrations of IL-8 and MCP-1 were significantly increased in infants who developed BPD (IL-8: P=0.0001; MCP-1: P<0.001, analysis of variance) and correlated with duration of mechanical ventilation and oxygen treatment. Uu-positive infants had an increased incidence of BPD (88% in infants with Uu vs 42% in infants without Uu; P=0.020) and had TA concentrations of IL-8 and MCP-1 that were significantly increased compared with those of Uu-negative infants.


CONCLUSIONS
Increased TA concentrations of IL-8 and MCP-1 during the first 2 weeks of life are associated with the development of BPD. Recovery of Uu from TAs is associated with a more robust inflammatory reaction and an increased risk of BPD.
Baier
R J
RJ
Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport 71130-3932, USA. jbaier@lsuhsc.edu
Loggins
J
J
Kruger
T E
TE
D001997:Bronchopulmonary Dysplasia / Q000209:etiology / Q000276:immunology* / Q000382:microbiology*; D018932:Chemokine CCL2 / Q000378:metabolism*; D005835:Genitalia / Q000382:microbiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism*; D011446:Prospective Studies; D014132:Trachea / Q000276:immunology; D016869:Ureaplasma Infections / Q000150:complications / Q000276:immunology; D016990:Ureaplasma urealyticum / Q000276:immunology / Q000302:isolation & purification* / Q000472:pathogenicity
D018932:Chemokine CCL2; D018836:Inflammation Mediators; D016209:Interleukin-8