title: Systemic fetal inflammation and reduced concentrations of macrophage migration inhibitory factor in tracheobronchial aspirate fluid of extremely premature infants.
abstract: OBJECTIVE
  Macrophage migration inhibitory factor is a proinflammatory mediator of innate immunity, enhances cell growth, and plays a role in preterm delivery. We speculated that funisitis, reflecting fetal systemic inflammation, would be associated with higher concentrations of macrophage migration inhibitory factor in airways of extremely premature infants.
  
  
  METHODS
  We measured macrophage migration inhibitory factor by enzyme linked immunosorbent assay in tracheobronchial aspirate fluid of 35 ventilated infants less than 30 weeks' gestational age, throughout the first week of life. Three groups were distinguished histologically: chorioamnionitis, funisitis, and control.
  
  
  RESULTS
  Unexpectedly, funisitis was associated with significantly decreased macrophage migration inhibitory factor in tracheobronchial aspirate fluid on day 1 (P < .01) and levels remained lower than in the chorioamnionitis group thereafter. For the 35 patients in total, macrophage migration inhibitory factor steadily declined.
  
  
  CONCLUSIONS
  Decreased macrophage migration inhibitory factor concentrations in airways of extremely premature infants with systemic fetal inflammation early in life might predispose them to pulmonary infection and interfere with maturation of the lung, contributing to adverse pulmonary outcome.
authors.affiliation: University Children's Hospital, University of Würzburg, Würzburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Thomas
authors.forename: Silvia
authors.initials: S
authors.lastname: Seidenspinner
authors.forename: Natalia
authors.initials: N
authors.lastname: Kawczyńska-Leda
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
authors.forename: Maria
authors.initials: M
authors.lastname: Chmielnicka-Kopaczyk
authors.forename: Alexander
authors.initials: A
authors.lastname: Marx
authors.forename: Marta
authors.initials: M
authors.lastname: Szymankiewicz
authors.forename: Christian P
authors.initials: CP
authors.lastname: Speer
mesh_terms: D000704:Analysis of Variance; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis* / Q000453:epidemiology; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000401:mortality; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000401:mortality; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D018836:Inflammation Mediators / Q000032:analysis; D007363:Intensive Care Units, Neonatal; D008263:Macrophage Migration-Inhibitory Factors / Q000032:analysis*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D018836:Inflammation Mediators; D008263:Macrophage Migration-Inhibitory Factors