title: High tissue factor in lungs and plasma associates with respiratory morbidity in preterm infants.
abstract: OBJECTIVE
  In preterm infants, inflammation and intra-alveolar fibrin formation characterize respiratory distress syndrome (RDS). Tissue factor (TF) is a link between inflammation and coagulation pathways. We investigated the relationship between TF and cytokines in preterm infants to gain information of the role of TF in the inflammatory response.
  
  
  METHODS
  We measured TF in plasma and in tracheal aspirates and analysed TF on monocytes by flow cytometry and 13 cytokines from plasma, in 56 preterm infants (birthweight 600-1500 g) during their first week.
  
  
  RESULTS
  Plasma TF increased and peaked on day 3 and correlated with both RDS and inversely with paO2/FIO2. On day 1, TF in tracheal aspirates was 10-fold higher than in plasma and correlated with plasma TF (4888 vs. 506 pg/mL, R = 0.692, p = 0.013, n = 12). Of main pro-inflammatory cytokines, plasma TF correlated post-natally with IL-8 and IL-6 but not with IL-1 or TNF-α.
  
  
  CONCLUSIONS
  Respiratory morbidity associates with high TF in lungs and plasma. In sick newborn infants, upregulation of TF may be mediated by IL-6 and IL-8. High TF and pro-inflammatory cytokines may together participate in the pathogenesis of pulmonary and extrapulmonary injury in preterm infants through pro-inflammatory mechanisms.
authors: Children's Hospital, Helsinki University Hospital, Helsinki, Finland. anniina.palojarvi@gmail.com
authors: Anniina
authors: A
authors: Palojärvi
authors: Sture
authors: S
authors: Andersson
authors: Sanna
authors: S
authors: Siitonen
authors: Cecilia
authors: C
authors: Janér
authors: Jari
authors: J
authors: Petäjä
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000378:metabolism*; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007249:Inflammation; D008168:Lung / Q000378:metabolism*; D008297:Male; D009017:Morbidity; D010949:Plasma / Q000737:chemistry*; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000378:metabolism*; D013925:Thromboplastin / Q000032:analysis* / Q000378:metabolism
chemical_list: D016207:Cytokines; D013925:Thromboplastin