Abstract
Background: In the early phases bronchopulmonary dysplasia (BPD) is characterized by epithelial and endothelial damage and inflammation. A recent study showed an absent or decreased concentration of keratinocyte growth factor, a factor contributing to epithelial repair, in early BPD (Danan C et al, Am J Respir Crit Care Med. 2002;165:1384–7).
Aim: To investigate whether bronchoalveolar lavage fluid (BALF) from preterm infants who develop BPD has a decreased capacity to stimulate epithelial repair compared to BALF from infants who recover from respiratory distress syndrome (RDS).
Methods: A standardized blind bronchoalveolar lavage was performed with 2x1 ml/kg saline in ventilated preterm infants with a gestational age <30 weeks on day 2 to 4 of life. Infants who recovered from RDS were all extubated within the first week of life. BPD was defined as oxygen requirement at 28 days of life. A bronchial epithelial cell line (BEAS) was grown to confluence and a scratch of known surface area was made in the epithelium (Geiser et al, Am J Physiol Lung Cell Mol Physiol 2000;279:L1184–90). BALF (or control medium without serum) was added to the cell cultures for 18 hours and the closure of the epithelial wound was assessed (expressed as % closure above control medium).
Results: BALF from infants who developed BPD (n=13) had a significantly lower capacity to stimulate epithelial wound closure than BALF from infants who recovered from RDS (n=10): 25±5% versus 48±4.5% closure above control medium (p=0.02 by t-test) (mean±SEM).
Conclusion: BALF on day 2 to 4 from preterm infants who develop BPD has a decreased capacity to stimulate epithelial repair in an in vitro assay compared to BALF from infants who recover from RDS. This suggests that besides epithelial injury also decreased epithelial repair plays a role in the early phase of BPD development. Further investigations are necessary to elucidate which growth factors or other factors are important for the decreased epithelial repair in the early phase of BPD development.
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Zimmermann, L., Versnel, M., Naber, B. et al. 275 Epithelial Repair in The Preterm Lung is Decreased in The Early Phase of Bronchopulmonary Dysplasia. Pediatr Res 56, 510 (2004). https://doi.org/10.1203/00006450-200409000-00298
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DOI: https://doi.org/10.1203/00006450-200409000-00298