Document Detail

Effect of dexamethasone therapy on fibronectin and albumin levels in lung secretions of infants with bronchopulmonary dysplasia.
MedLine Citation:
PMID:  1403398     Owner:  NLM     Status:  MEDLINE    
The influence of dexamethasone on levels of total fibronectin (tFn), cellular fibronectin (cFn), plasma fibronectin (pFn), and albumin in lung secretions was determined in tracheal aspirate samples collected from 45 infants with bronchopulmonary dysplasia during a 6-week course of dexamethasone therapy. Secretory component for IgA (SC) was used as a reference protein. Thirty-seven infants (82%) survived and had their endotracheal tubes successfully removed. Corticosteroid therapy was associated with a significant decrease in the cFn/SC ratio. There was also a significant decrease in albumin/SC and pFn/SC ratios, suggesting decreased capillary permeability with corticosteroid therapy. Four of the remaining infants did not improve while receiving corticosteroids and died of respiratory failure at 3 to 8 weeks of age. In these "no response" infants, tFn/SC, cFn/SC, pFn/SC, and albumin/SC ratios when corticosteroid therapy was initiated were threefold to fourfold greater (p < 0.01) than ratios in survivors. Another group of four infants initially responded to corticosteroids but subsequently died with severe pulmonary cystic degeneration at 4 to 6 months of age; in these infants, tracheal aspirate tFn/SC, cFn/SC, and albumin/SC ratios were significantly lower than in survivors and remained unchanged during corticosteroid therapy. The decrease in the concentrations of plasma fibronectin and albumin in tracheal aspirate samples from the survivors suggests that the rapid clinical improvement seen in infants with bronchopulmonary dysplasia after the initiation of dexamethasone therapy is due in part to improvement in the integrity of the alveolar-capillary barrier. In addition, the decrease in the aspirate levels of cFn suggests the potential for corticosteroids to limit pulmonary fibrosis in the surviving infants. The depressed levels of fibronectin observed in the infants with severe cystic lung disease may represent an impaired healing response to lung injury.
C L Watts; M C Bruce
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  121     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-11-13     Completed Date:  1992-11-13     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  597-607     Citation Subset:  AIM; IM    
Department of Pediatrics, Rainbow Babies and Childrens Hospital, Case Western Reserve University, Cleveland, Ohio 44106.
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MeSH Terms
Albumins / analysis*
Bronchopulmonary Dysplasia / blood,  drug therapy*,  mortality
Dexamethasone / pharmacology,  therapeutic use*
Fibronectins / analysis*,  blood
Immunoglobulin A, Secretory / analysis
Infant, Newborn
Lung / drug effects*,  secretion
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Albumins; 0/Fibronectins; 0/Immunoglobulin A, Secretory; 50-02-2/Dexamethasone

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