Document Detail


Increased leukocyte elastase of the tracheal aspirate at birth and neonatal pulmonary emphysema.
MedLine Citation:
PMID:  8414828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors have previously shown the association of elevated neonatal serum IgM and chorioamnionitis in infants in whom pulmonary emphysema characteristic of Wilson-Mikity syndrome subsequently developed. This paper extends the observation to the measurement of polymorphonuclear leukocyte elastase-alpha 1-proteinase inhibitor complex (PMN elastase-alpha 1-PI) in tracheal aspirates of infants with chronic lung disease. PATIENTS: Tracheal aspirates were obtained from 90 very low birth weight neonates within 24 hours of birth. Serum also was collected within 72 hours of birth, and placentas were examined for signs of inflammation. RESULTS: The mean PMN elastase-alpha 1-PI was significantly elevated (21.8 micrograms/mg albumin) in infants with a pulmonary emphysema syndrome like that designated by Wilson-Mikity compared either with those with bronchopulmonary dysplasia (1.5 micrograms/mg albumin, P < .01) or those with respiratory distress syndrome in whom bronchopulmonary dysplasia did not develop (2.3 micrograms/mg albumin, P < .01). Infants with pulmonary emphysema had a significantly elevated mean serum IgM and a high incidence of chorioamnionitis. CONCLUSIONS: The level of PMN elastase-alpha 1-PI was increased in the tracheal aspirates of newborns in whom pulmonary emphysema developed. Intrauterine inflammation may increase the level of PMN elastase in the fetal respiratory tract. This increase in PMN elastase-alpha 1-PI in fetal lung tissue may cause lung injury in utero, resulting in postnatal pulmonary emphysema consistent with the Wilson-Mikity syndrome following ventilation.
Authors:
M Fujimura; H Kitajima; M Nakayama
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  92     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-02     Completed Date:  1993-11-02     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  564-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neonatal Medicine, Osaka Medical Center, Japan.
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MeSH Terms
Descriptor/Qualifier:
Bronchopulmonary Dysplasia / metabolism
Chorioamnionitis / complications
Female
Humans
Immunoglobulin M / analysis
Infant, Low Birth Weight / metabolism*
Infant, Newborn
Leukocyte Elastase
Male
Pancreatic Elastase / metabolism*
Pregnancy
Pulmonary Emphysema / etiology,  metabolism*
Respiratory Distress Syndrome, Newborn / metabolism
Syndrome
Trachea / enzymology*
alpha 1-Antitrypsin / metabolism*
Chemical
Reg. No./Substance:
0/Immunoglobulin M; 0/alpha 1-Antitrypsin; EC 3.4.21.36/Pancreatic Elastase; EC 3.4.21.37/Leukocyte Elastase

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