Kakkera Deepika K, Siddiq Mustafa M, Parton Lance A
Divisions of Neonatology, Departments of Pediatrics, State University of New York at Stony Brook, New York, NY, USA.
Biol Neonate. 2005;87(2):82-90. doi: 10.1159/000081504. Epub 2004 Oct 14.
The local pulmonary balance between the agonist and antagonist of interleukin-1 (IL-1) may influence the development of inflammatory disease and resultant structural damage in a variety of human diseases including adult respiratory distress syndrome and asthma.
We tested the hypothesis that IL-1 cytokines are early markers for bronchopulmonary dysplasia (BPD), when measured in tracheal aspirates (TAs) obtained from premature infants being ventilated for respiratory distress syndrome during the first week of life.
Serial TAs were collected on days 1, 3, 5 and 7 from 35 preterm infants (16 BPD, 19 non-BPD) in the absence of chorioamnionitis, and were assayed for IL-1 cytokines and leukocytes.
In spite of comparable maternal demographic and clinical characteristics, premature infants who developed BPD had higher levels of IL-1 receptor antagonist (Ra) in their airways on the first day of life. This antagonist IL-1Ra was an early and persistent marker for BPD during the first week of life. The agonist IL-1beta also increased significantly for BPD patients early, both compared to non-BPD patients, and also within the BPD group. While the early (day 1) IL-1 antagonist/agonist molar balance offered protection, by days 5 and 7, a threshold for IL-1Ra in the presence of increasing IL-1beta expression-favored pro-inflammation in the BPD group.
We conclude that a strong and early expression of airway antagonist (IL-1Ra) proves ultimately to be sub-optimal and non-protective due to the robust expression of airway agonist (IL-1beta) seen by day 5 in premature infants who develop BPD.
白细胞介素-1（IL-1）激动剂与拮抗剂之间的局部肺平衡可能会影响多种人类疾病（包括成人呼吸窘迫综合征和哮喘）中炎症性疾病的发展及由此导致的结构损伤。
我们检验了这样一个假设，即在生命第一周因呼吸窘迫综合征接受机械通气的早产儿的气管吸出物（TA）中检测到的IL-1细胞因子是支气管肺发育不良（BPD）的早期标志物。
在无绒毛膜羊膜炎的情况下，从35例早产儿（16例患BPD，19例未患BPD）中于第1、3、5和7天收集系列TA，并检测其中的IL-1细胞因子和白细胞。
尽管母亲的人口统计学和临床特征具有可比性，但患BPD的早产儿在出生第一天气道中的IL-1受体拮抗剂（Ra）水平较高。这种拮抗剂IL-1Ra是生命第一周BPD的早期且持续存在的标志物。与未患BPD的患者相比，以及在BPD组内，BPD患者的激动剂IL-1β早期也显著增加。虽然早期（第1天）IL-1拮抗剂/激动剂摩尔平衡具有保护作用，但到第5天和第7天，在IL-1β表达增加的情况下，IL-1Ra的一个阈值有利于BPD组中的促炎反应。
我们得出结论，由于在患BPD的早产儿中到第5天时气道激动剂（IL-1β）的强劲表达，气道拮抗剂（IL-1Ra）的强烈且早期表达最终被证明是次优的且无保护作用。
