title: [Effect of pulmonary surfactant on Th1/Th2 balance in neonates with respiratory distress syndrome].
abstract: OBJECTIVE
  To investigate the effect of pulmonary surfactant (PS) on the Th1/Th2 balance and serum levels of interleukin-4 (IL-4), interferon-γ (IFN-γ) and IgE in neonates with respiratory distress syndrome (RDS).
  
  
  METHODS
  A total of 58 neonates with RDS were divided into control (n=20) and PS treatment groups (n=38). The control group underwent mechanical ventilation and other conventional treatment, while the PS treatment group received with bovine PS treatment within 1 hour of being admitted to the hospital together with mechanical ventilation and other conventional treatment. Enzyme-linked immunosorbent assay was used to measure serum levels of IL-4, IFN-γ and IgE before treatment and 24, 48 and 72 hours after treatment. Simultaneously, arterial blood gas, respiratory system compliance, and other ventilator parameters were recorded.
  
  
  RESULTS
  Compared with the control group, the PS treatment group showed significantly shorter duration of mechanical ventilation and oxygen exposure time (P<0.05), significantly better respiratory system compliance and significantly lower oxygenation index 24, 48 and 72 hours after treatment (P<0.05). At 48 and 72 hours after treatment, serum levels of IFN-γ were significantly lower in the PS treatment group than in the control group (120±46 ng/L vs 229±59 ng/L, P<0.05; 141±40 ng/L vs 282±44 ng/L, P<0.05), and serum levels of IL-4 were significantly higher in the PS treatment group than in the control group (263±48 pg/mL vs 152±45 pg/mL, P<0.05; 417±49 pg/mL vs 201±46 pg/mL, P<0.05). At 72 hours after treatment, serum level of IgE was significantly lower in the PS treatment group than in the control group (115±44 pg/mL vs 199±43 ng/mL; P<0.05).
  
  
  CONCLUSIONS
  PS treatment can shorten the duration of mechanical ventilation and oxygen exposure time, regulate serum levels of IFN-γ, IL-4 and IgE, and influence Th1/Th2 balance in neonates with RDS, thus inhibiting lung inflammatory response and reducing lung injury.
authors.affiliation: Department of Neonatology, Handan Central Hospital, Handan, Hebei, China. shufenzhai@gmail.com
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Zhai
authors.forename: Cui-Qing
authors.initials: CQ
authors.lastname: Liu
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Ping
authors.forename: Bao-Li
authors.initials: BL
authors.lastname: Tian
mesh_terms: D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007231:Infant, Newborn; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D011663:Pulmonary Surfactants / Q000494:pharmacology / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*
chemical_list: D011663:Pulmonary Surfactants; D015847:Interleukin-4; D007073:Immunoglobulin E; D007371:Interferon-gamma