Serum monocyte chemotactic protein-1 levels in congenital diaphragmatic hernia.
To measure serum monocyte chemotactic protein-1 (MCP-1) in patients with congenital diaphragmatic hernia (CDH) and investigate its relationship to the development of persistent pulmonary hypertension (PPH). Serum MCP-1 was measured in 13 neonates with high risk for CDH at the time of diagnosis and postoperatively, and in five age-matched controls using an ELISA system. The 13 CDH subjects were divided into four groups according to the presence of PPH and outcome. Group I (severe-pre group): subjects with severe PPH who died prior to surgery (n = 5); Group II (mild-pre group): subjects with mild PPH controlled by medications (n = 8); Group IIa (severe-post group): subjects who subsequently developed severe PPH postoperatively and died (n = 3); and Group IIb (mild-post group): subjects who continued to have mild PPH controlled by medications. We also examined nitrofen-induced hypoplastic lungs from five rat fetuses with CDH and five control lung specimens for MCP-1 using immunohistochemistry. Mean serum MCP-1 in Group I was (1038.0 +/- 95.8 pg/ml), which was significantly higher than Group II (444.9 +/- 39.7 pg/ml) (P < 0.0001) and controls (147.3 +/- 11.3 pg/ml) (P < 0.0001). Postoperatively, Group IIa was significantly higher than Group IIb from 24 to 120 h postoperatively (P < 0.001). In Group IIb serum MCP-1 did not rise at all between 24 and 120 h postoperatively. Hypoplastic fetal rat CDH lungs had strong expression of MCP-1 compared with control lungs. Up-regulated expression and high circulating levels of MCP-1 in CDH patients with PPH suggest that MCP-1 may play a role in the development of PPH in CDH.
Okawada
Manabu
M
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Kobayashi
Hiroyuki
H
Tei
Eri
E
Okazaki
Tadaharu
T
Lane
Geoffrey J
GJ
Yamataka
Atsuyuki
A
D000818:Animals; D015415:Biomarkers / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood*; D003964:Diaphragm / Q000601:surgery; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006548:Hernia, Diaphragmatic / Q000097:blood* / Q000150:complications*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood* / Q000209:etiology*; D011184:Postoperative Period; D051381:Rats; D012720:Severity of Illness Index; D013997:Time Factors; D014463:Ultrasonography
D015415:Biomarkers; D018932:Chemokine CCL2