Early inflammatory mediator patterns in tracheal aspirate and the association with bronchopulmonary dysplasia (BPD) in low birth weight neonates Open Access

Abstract

Despite advancements in the care of preterm neonates, the prevalence of
bronchopulmonary dysplasia (BPD), a chronic lung disorder of neonates, in extremely
premature infants has not decreased. While the etiology of BPD is thought to be
multifactorial, studies have shown that alterations in pro- and anti-inflammatory
mediators are an important modification in lungs of neonates who develop BPD. It is
known that individual inflammatory mediators are involved in the development of BPD;
however, there is a lack of current research examining the relationship between multiple
inflammatory mediators in the lungs of premature neonates and the subsequent
development of BPD. A pilot cross-sectional study was conducted in order to investigate
whether the distribution of 12 inflammatory mediators detected in the tracheal aspirate
(TA) of neonates within 24 hours of birth could differentiate between low birth weight
neonates who did and did not develop BPD. TA samples were collected from 27
mechanically ventilated preterm neonates weighing less than 1,500 grams. BPD was
diagnosed in 11 of the neonates at 36 weeks post-conceptional age. TA concentrations of
IL-1ra, IL-1b, IL-4, IL-6, IL-8, IL-10, GM-CSF, VEGF, MCP-1, MIP-1a, MIP-1b, and
TNF-alpha were determined by quantitative bead-based multiplex assay. There was no
significant difference found between neonates who developed BPD and those who did
not when individual levels of markers were compared. A linear discriminate analysis
used to classify patients into those who did and those who did not develop BPD, based on
the 12 measured biomarkers, displayed a significant level of discriminant function
(p=0.007). While the levels of individual inflammatory mediators in low birth weight
neonates at 24 hours may not differ between neonates who do and do not develop BPD,
multiple inflammatory mediators can be used to classify neonates into who will and will
not develop BPD.

Table of Contents

TABLE OF CONTENTS

INTRODUCTION
1-2

BACKGROUND
3-5

METHODS



6-9

RESULTS

10-13

DISCUSSION
14-16

REFERENCES 17-19

TABLES AND FIGURES

20-30

TABLE
I
20

TABLE
II
21

TABLE
III
22

TABLE
IV
23

TABLE
V
24

TABLE
VI
25

TABLE
VII
26

TABLE
VIII
27

TABLE
IX
28

TABLE
X
29

FIGURE
I
30

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Laney Graduate School
Department	Clinical Research Curriculum Program
Degree	MS
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Medicine and Surgery
Keyword	Neonatology Cytokine BPD Inflammatory Mediator Bronchopulmonary dysplasia
Committee Chair / Thesis Advisor	Gauthier, Theresa, Emory University
Committee Members	Boring, John R, Emory University McGowan Jr., John E, Emory University Manatunga, Amita, Emory University

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