title: Tracheal aspirate gene expression in preterm newborns and development of bronchopulmonary dysplasia.
abstract: BACKGROUND
  Bronchopulmonary dysplasia (BPD) occurs in association with prenatal conditions predisposing infants to inflammation and remodeling of the premature lungs. Because of the lack of useful biomarkers for BPD, the gene expression of tracheal aspirate fluid (TAF) cells in premature infants was analyzed.
  
  
  METHODS
  Of 148 consecutive patients, 26 preterm infants (gestational age <34 weeks) were enrolled, who underwent assisted ventilation at birth for respiratory failure. Patients with congenital disorders were excluded. Half of these infants developed BPD. Interleukin (IL)-10, interferon (IFN)-γ, transforming growth factor (TGF)-β1, and platelet-derived growth factor (PDGF)-B mRNA of TAF cells were quantified on real-time polymerase chain reaction.
  
  
  RESULTS
  IL-10 (P < 0.01) and IFN-γ (P= 0.03) but not TGF-β1 or PDGF-B mRNA levels at birth were higher in BPD than in non-BPD infants. IL-10 expression differentiated BPD with the highest sensitivity (92%) and specificity (77%). IL-10 levels correlated with TGF-β1 (P= 0.03) and IFN-γ (P= 0.01), but not with PDGF-B levels. When BPD infants were classified according to comorbidity (group 1, six patients who suffered respiratory distress syndrome [RDS] but not chorioamnionitis [CAM]; group 2, five patients who had CAM but not RDS), PDGF-B levels were higher in group 2 (P= 0.01). High IL-10 expression was selected as a risk factor for BPD in infants who had CAM but not RDS (P= 0.01), although prolonged oxygen therapy was the most sensitive indicator for BPD (P < 0.01) on multivariate analysis.
  
  
  CONCLUSIONS
  High IL-10 expression in TAF cells at birth could predict the evolution of BPD, but with less impact than oxygen requirement. PDGF might play a different role in the inflammatory process of premature lungs.
authors: Departments of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Shunji
authors: S
authors: Hikino
authors: Shouichi
authors: S
authors: Ohga
authors: Tadamune
authors: T
authors: Kinjo
authors: Takeshi
authors: T
authors: Kusuda
authors: Masayuki
authors: M
authors: Ochiai
authors: Hirosuke
authors: H
authors: Inoue
authors: Satoshi
authors: S
authors: Honjo
authors: Kenji
authors: K
authors: Ihara
authors: Koichi
authors: K
authors: Ohshima
authors: Toshiro
authors: T
authors: Hara
mesh_terms: D015415:Biomarkers; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology; D016207:Cytokines / Q000032:analysis / Q000235:genetics*; D005122:Exudates and Transudates; D005260:Female; D015870:Gene Expression; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D036341:Intercellular Signaling Peptides and Proteins / Q000235:genetics; D007371:Interferon-gamma / Q000032:analysis; D016753:Interleukin-10 / Q000032:analysis*; D008297:Male; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology; D011446:Prospective Studies; D020574:Proto-Oncogene Proteins c-sis / Q000032:analysis; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D014132:Trachea / Q000166:cytology / Q000378:metabolism*; D053773:Transforming Growth Factor beta1 / Q000032:analysis
chemical_list: D015415:Biomarkers; D016207:Cytokines; D036341:Intercellular Signaling Peptides and Proteins; D020574:Proto-Oncogene Proteins c-sis; D053773:Transforming Growth Factor beta1; D016753:Interleukin-10; D007371:Interferon-gamma