| Persistent elastase/proteinase inhibitor imbalance during prolonged ventilation of infants with bronchopulmonary dysplasia: evidence for the role of nosocomial infections. | |
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MedLine Citation:
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PMID: 2797948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Acute imbalance between elastase and alpha-1-proteinase inhibitor (alpha 1Pi) may contribute to the development of bronchopulmonary dysplasia (BPD). The question of whether such an imbalance persists in BPD infants still requiring mechanical ventilation after 4 wk of life has not been previously addressed. We studied 14 infants still on mechanical ventilation at 4 wk of age: nine had BPD and five did not. Weekly (4 to 9 wk) serum and bronchoalveolar lavage (BAL) specimens were taken. alpha 1Pi and alpha-2-macroglobulin were measured in serum and BAL by immunoturbidimetric assay. BAL elastase activity was measured by cleavage of a synthetic substrate and expressed as ng of porcine pancreatic elastase equivalent. Infants with BPD had higher levels of serum alpha 1Pi and alpha-2-macroglobulin than those without BPD. In contrast, the corresponding BAL levels were either similar or even decreased (alpha 1Pi). Moreover, there was a 3-fold increase in elastase-1Pi imbalance expressed as the BAL ng of porcine pancreatic elastase equivalent/2 alpha 1Pi ratio. The role of nosocomial infections was evident in a subgroup of 11 infected BAL aspirates in BPD infants. In such cases we found a 3-fold increase in the BAL ng of porcine pancreatic elastase equivalent/alpha 1Pi ratio as compared to 35 noninfected BAL in BPD infants. These data suggest a persistent alveolitis with imbalance between elastase and proteinase inhibitors in prolonged severe BPD. Such an imbalance is, in part, explained by a local destruction and/or inactivation of alpha 1Pi. Our results also emphasize the increase in proteolysis with nosocomial pneumonia. |
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Authors:
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H Walti; C Tordet; L Gerbaut; P Saugier; G Moriette; J P Relier |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pediatric research Volume: 26 ISSN: 0031-3998 ISO Abbreviation: Pediatr. Res. Publication Date: 1989 Oct |
Date Detail:
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Created Date: 1989-11-07 Completed Date: 1989-11-07 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 351-5 Citation Subset: IM |
Affiliation:
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Neonatal Intensive Care Unit, Port-Royal Maternity, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bronchoalveolar Lavage Fluid
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metabolism Bronchopulmonary Dysplasia / complications, metabolism*, therapy Cross Infection / complications, metabolism* Humans Infant, Low Birth Weight / metabolism* Infant, Newborn Pancreatic Elastase / metabolism* Prospective Studies Respiration, Artificial* Serum Albumin / metabolism alpha 1-Antitrypsin / metabolism* |
| Chemical | |
Reg. No./Substance:
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0/Serum Albumin; 0/alpha 1-Antitrypsin; EC 3.4.21.36/Pancreatic Elastase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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