Systemic fetal inflammation and reduced concentrations of macrophage migration inhibitory factor in tracheobronchial aspirate fluid of extremely premature infants

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...

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Published in:American journal of obstetrics and gynecology 2008, Vol.198 (1), p.64.e1-64.e6
Main Authors: Thomas, Wolfgang, MD, Seidenspinner, Silvia, Kawczyńska-Leda, Natalia, MD, Kramer, Boris W., MD, Chmielnicka-Kopaczyk, Maria, MD, Marx, Alexander, MD, Szymankiewicz, Marta, PhD, Speer, Christian P., MD
Format: Article
Language:English
Subjects:
Analysis of Variance
Biological and medical sciences
Bronchoalveolar Lavage Fluid - chemistry
bronchopulmonary dysplasia
Bronchopulmonary Dysplasia - diagnosis
Bronchopulmonary Dysplasia - epidemiology
Chorioamnionitis - diagnosis
Chorioamnionitis - mortality
Cohort Studies
Diseases of mother, fetus and pregnancy
Enzyme-Linked Immunosorbent Assay
Female
Fetal Diseases - diagnosis
Fetal Diseases - mortality
fetal inflammatory response syndrome
Follow-Up Studies
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
Incidence
Infant Mortality
Infant, Newborn
Infant, Very Low Birth Weight
Inflammation Mediators - analysis
Intensive Care Units, Neonatal
lung development
Macrophage Migration-Inhibitory Factors - analysis
Male
Medical sciences
Obstetrics and Gynecology
Pregnancy
Pregnancy Outcome
Pregnancy. Fetus. Placenta
prematurity
Probability
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Statistics, Nonparametric
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Summary: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. Study Design 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. Conclusion 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.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2007.06.010