Document Detail


Comparison of secretory component for immunoglobulin A with albumin as reference proteins in tracheal aspirate from preterm infants.
MedLine Citation:
PMID:  7608795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether the concentration of secretory component (SC) in tracheal aspirate samples is less altered by changes in alveolar-capillary permeability and thus is a more reliable reference standard than albumin for the measurement of other components obtained by saline lavage in preterm infants. METHODS: A total of 1229 tracheal aspirate and 1530 blood samples were collected from 195 neonates to evaluate the effects of advancing postnatal and gestational age, resolution of acute respiratory distress syndrome (RDS), steroid therapy for chronic lung disease, and acute sepsis on tracheal aspirate SC and albumin levels. The tracheal aspirate and blood samples were analyzed by enzyme-linked immunosorbent assay techniques for SC and albumin concentrations. RESULTS: The mean values for the concentrations of aspirate and plasma SC did not vary significantly during an 8-week study period (n = 100) and did not vary with either gestational age (23 to 36 weeks) or postnatal age. Albumin concentration significantly decreased in aspirate samples from 1.67 +/- 0.77 mg/dl at week 1 to 0.41 +/- 0.21 mg/dl at week 8 (p < 0.001), whereas serum levels increased from 2.65 +/- 0.36 to 2.99 +/- 0.54 gm/dl (p < 0.001), suggesting a decrease in alveolar-capillary leakage with advancing postnatal age. The concentration of SC in aspirate samples from 51 infants who received dexamethasone remained constant during the first week of therapy, whereas the concentration of albumin decreased from 1.33 +/- 0.91 mg/dl at the initiation of therapy to 0.51 +/- 0.34 mg/dl on treatment day 7 (p < 0.001). The onset of sepsis (n = 40) was not accompanied by a significant change in either aspirate SC or albumin levels. However, in infants who had a deterioration in respiratory status concomitant with the onset of sepsis (n = 10), the levels of aspirate albumin increased whereas serum levels decreased (p < 0.001), suggesting an increase in alveolar-capillary leakage; the levels of aspirate SC remained unaltered. CONCLUSIONS: Secretory component may serve as a more valid reference protein for the standardization of tracheal aspirate collection in preterm infants during evaluation of changes in inflammatory mediators in disease states and therapeutic interventions that alter alveolar-capillary integrity.
Authors:
C L Watts; M C Bruce
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  127     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-08-11     Completed Date:  1995-08-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  113-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Rainbow Babies & Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Blood Gas Analysis
Bronchopulmonary Dysplasia / blood,  drug therapy
Enzyme-Linked Immunosorbent Assay
Gestational Age
Humans
Immunoglobulin A / blood*
Infant, Newborn
Infant, Premature*
Respiration, Artificial
Respiratory Distress Syndrome, Newborn / blood,  rehabilitation
Sepsis / blood
Serum Albumin / analysis*
Steroids / therapeutic use
Trachea / secretion*
Grant Support
ID/Acronym/Agency:
HL31172/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Immunoglobulin A; 0/Serum Albumin; 0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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