Milk protein and Oil-Red-O staining of alveolar macrophages in chronic respiratory disease of infancy.
Aspiration is a suspected cause of chronic respiratory disease in infants. We assessed the probability of aspiration by immunocytochemical staining of alveolar macrophages for milk proteins (α-lactalbumin and β-lactoglobulin) and compared these findings with the Oil-Red-O staining score. Broncho-alveolar lavage (BAL), 24-hr esophageal pH-measurement and/or gastro-esophageal scintigraphy were performed in 111 children. Seventy-nine patients were enrolled. Ten exclusively soya milk formula fed children served as a control group. Individual scores, expressed as the mean percentage of positive staining macrophages counted by three blinded authors were made. Relying on the control group, a positive score was defined as a value higher than 1%. A positive score was found in 26% (18/69). Forty-four percent (8/18) of them had positive gastro-esophageal reflux (GER) tests. In 61% (11/18) a concomitant diagnosis of laryngo-/tracheomalacia was made. A positive score was found in 48% (11/23) of patients with laryngo-/tracheomalacia, compared to 15% (7/46) in infants with normal laryngeal and tracheal anatomy. No correlation was found between the immunocytochemical staining score for milk proteins and the Oil-Red-O staining score. We conclude that assuming the 1% criterion, persistent respiratory symptoms were associated with a positive immunostaining score, suggestive for aspiration, in 26% of infants, in 48% in case of concomitant laryngo- and/or tracheomalacia and in 15% of infants with normal laryngeal and tracheal anatomy. No correlation was found between the immunocytochemical staining score for cow milk proteins and the Oil-Red-O staining score.
De Baets
Frans
F
Department of Pediatric Pulmonology, Ghent University Hospital, Ghent, Belgium. frans.debaets@ugent.be
Aarts
Claudia
C
Van Daele
Sabine
S
Haerynck
Filomeen
F
De Wachter
Elke
E
De Schutter
Iris
I
Malfroot
Anne
A
Schelstraete
Petra
P
D001391:Azo Compounds / Q000378:metabolism*; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy; D016022:Case-Control Studies; D002675:Child, Preschool; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007768:Lactalbumin / Q000378:metabolism*; D007782:Lactoglobulins / Q000378:metabolism*; D055092:Laryngomalacia / Q000150:complications; D008264:Macrophages / Q000378:metabolism*; D008297:Male; D011650:Pulmonary Alveoli / Q000166:cytology*; D011877:Radionuclide Imaging; D053120:Respiratory Aspiration / Q000175:diagnosis*; D013194:Staining and Labeling; D013270:Stomach / Q000000981:diagnostic imaging; D055090:Tracheomalacia / Q000150:complications
D001391:Azo Compounds; D007782:Lactoglobulins; D007768:Lactalbumin; C011049:oil red O