Sarafidis K, Drossou-Agakidou V, Kanakoudi-Tsakalidou F, Taparkou A, Tsakalidis C, Tsandali C, Kremenopoulos G
Department of Neonatology, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.
Pediatr Pulmonol. 2001 Mar;31(3):214-9. doi: 10.1002/ppul.1031.
Several observations imply that the early inflammatory response involving activated neutrophils, tissue macrophages, and cytokines plays an important role in the pathogenesis of neonatal respiratory distress syndrome (RDS) and progression to bronchopulmonary dysplasia (BPD). The aim of this study was to test the hypothesis that changes in circulating neutrophil number and function and plasma levels of cytokines, consistent with neutrophil activation and migration to the tissues, occur during the early stages of neonatal RDS. For this purpose we measured peripheral blood levels of certain immunological parameters that promote neutrophil activation and transendothelial migration. Twenty preterm neonates with severe RDS and 20 healthy infants matched for gestational age were the subjects. The absolute neutrophil count (ANC), and plasma levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and sL-selectin using an enzyme-linked immunosorbent assay (ELISA), neutrophil CD11b expression, and respiratory burst activity (RBA) using flow cytometry, were measured within 24 h after birth. The two groups were comparable regarding perinatal characteristics. None of the neonates studied had any clinical or laboratory evidence of infection by the time of blood sampling. The immunological investigation showed that the RDS neonates had significantly lower ANC (P = 0.032), higher expression of the CD11b on neutrophils (P = 0.0065), and higher G-CSF and IL-6 plasma levels (P = 0.0047 and P < 0.0001, respectively) in comparison to healthy preterm neonates. The neutrophil RBA and plasma sL-selectin levels did not differ significantly between the two groups. We conclude that in neonates with severe RDS, there is evidence of a systemic neutrophil activation early in the course of the disease, supporting the view of a contributing role of activated neutrophils in the pathogenesis of RDS.
多项观察结果表明，涉及活化中性粒细胞、组织巨噬细胞和细胞因子的早期炎症反应在新生儿呼吸窘迫综合征（RDS）的发病机制及进展为支气管肺发育不良（BPD）的过程中起重要作用。本研究的目的是检验以下假设：在新生儿RDS的早期阶段，循环中性粒细胞数量和功能以及细胞因子血浆水平的变化与中性粒细胞活化及向组织迁移相一致。为此，我们测量了促进中性粒细胞活化和跨内皮迁移的某些免疫参数的外周血水平。研究对象为20例患有严重RDS的早产儿和20例胎龄匹配的健康婴儿。出生后24小时内，采用酶联免疫吸附测定（ELISA）法测量绝对中性粒细胞计数（ANC）、白细胞介素-6（IL-6）、粒细胞集落刺激因子（G-CSF）和可溶性L-选择素的血浆水平，采用流式细胞术测量中性粒细胞CD11b表达和呼吸爆发活性（RBA）。两组在围产期特征方面具有可比性。在采血时，所研究的新生儿均无任何感染的临床或实验室证据。免疫学调查显示，与健康早产儿相比，RDS新生儿的ANC显著降低（P = 0.032），中性粒细胞上CD11b的表达更高（P = 0.0065），G-CSF和IL-6血浆水平更高（分别为P = 0.0047和P < 0.0001）。两组之间中性粒细胞RBA和血浆可溶性L-选择素水平无显著差异。我们得出结论，在患有严重RDS的新生儿中，有证据表明在疾病早期存在全身性中性粒细胞活化，这支持了活化中性粒细胞在RDS发病机制中起作用的观点。
