Angiopoietin 2 concentrations in infants developing bronchopulmonary dysplasia: attenuation by dexamethasone.
OBJECTIVE
To study the association between angiopoietin 2 (Ang2) concentrations in tracheal aspirates (TAs) and adverse outcome (bronchopulmonary dysplasia (BPD)/death) in ventilated premature infants (VPIs) and modulation of Ang2 concentrations with dexamethasone (Dex) use.


METHODS
Serial TA samples were collected on days 1, 3, 5 and 7, and Ang2 concentrations were measured. Ang2 TA concentrations were compared prior to and after 48 to 72 h of using Dex.


RESULTS
A total of 151 TA samples were collected from 60 VPIs. BPD was defined as the oxygen requirement at 36 weeks postmenstrual age (PMA). Twelve infants (mean+/-s.d.) (gestational age (GA) 26.5+/-2.1 weeks, birth weight (BW) 913+/-230 g) had no BPD, 32 infants (GA 25.8+/-1.4 weeks, BW 768+/-157 g) developed BPD and 16 infants (GA 24.5+/-1.1 weeks, BW 710+/-143 g) died before 36 weeks PMA. Ang2 concentrations were significantly lower in infants with no BPD (median, 25th and 75th percentile) (157, 16 and 218 pg mg(-1)) compared with those who developed BPD (234, 138 and 338 pg mg(-1), P=0.03) or BPD and/or death (234, 157 and 347 pg mg(-1), P=0.017), in the first week of life. Twenty-six VPIs (BW 719+/-136 g, GA 25.1+/-1.3 weeks) received 27 courses of Dex. Ang2 concentrations before starting Dex were 202, 137 and 278 pg mg(-1) and significantly decreased to 144, 0 and 224 pg mg(-1) after therapy (P=0.007).


CONCLUSIONS
Higher Ang2 concentrations in TAs are associated with the development of BPD or death in VPIs. Dex use suppressed Ang2 concentrations.
Aghai
Z H
ZH
Department of Pediatrics, Cooper University Hospital Robert Wood Johnson Medical School, UMDNJ Camden, NJ, USA.
Faqiri
S
S
Saslow
J G
JG
Nakhla
T
T
Farhath
S
S
Kumar
A
A
Eydelman
R
R
Strande
L
L
Stahl
G
G
Leone
P
P
Bhandari
V
V
D042702:Angiopoietin-2 / Q000097:blood* / Q000502:physiology; D001826:Body Fluids / Q000737:chemistry; D001997:Bronchopulmonary Dysplasia / Q000097:blood* / Q000503:physiopathology; D003907:Dexamethasone / Q000494:pharmacology* / Q000627:therapeutic use; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D014132:Trachea / Q000737:chemistry
D042702:Angiopoietin-2; D005938:Glucocorticoids; D003907:Dexamethasone