Abstract 150

Background and aim: Reactive oxygen species seem to play an important role in lung injury of preterm infants. In the present study free iron, the generation of OH-radicals and iron-binding proteins in broncheoalveolar secretions (BAS) of neonates with RDS and developing chronic lung disease (CLD) have been evaluated. Patients and methods: 35 mechanically ventilated preterm infants (birth weight: 885g, gestational age: 27+3 (median)); 17 infants developed CLD (CLD-group), 18 infants recovered from RDS (RDS-group). BAS was sequentially obtained within the first 6 days of life. Free iron was detected by bleomycin-assay, generation of OH-radicals with electron paramagnetic resonance (EPR), total iron by atomic absorption spectroscopy. Transferrin was determined by a specially developed EIA, ferritin and albumin by routine methods. Results: 63% of all neonates had detectable free iron within the first 3 days of life and 83% in the following time-period (day 4-6). Representative in vitro studies with EPR indicated that OH-radicals can be artificially generated in BAS of neonates. Total iron (*day 2/5) and proteins were distributed in BAS in both groups as follows (median): Table

Table 1
Full size table

Conclusions: Free iron in BAS was present in the majority of infants with RDS. Infants with developing CLD had elevated transferrin and albumin levels within the first 3 days, indicating an increased alveolar capillary leakage, whereas high ferritin levels could result from damage of alveolar cells. We presume a reduced capacity of iron binding proteins in the alveolar system of preterm infants.

(This work was supported by the fortüne-project Nr.281 and the DFG SP 239 4-2.)