Thomas Wolfgang, Seidenspinner Silvia, Kawczyńska-Leda Natalia, Kramer Boris W, Chmielnicka-Kopaczyk Maria, Marx Alexander, Szymankiewicz Marta, Speer Christian P
University Children's Hospital, University of Würzburg, Würzburg, Germany.
Am J Obstet Gynecol. 2008 Jan;198(1):64.e1-6. doi: 10.1016/j.ajog.2007.06.010.
Macrophage migration inhibitory factor is a proinflammatory mediator of innate immunity, enhances cell growth, and plays a role in preterm delivery. We speculated that funisitis, reflecting fetal systemic inflammation, would be associated with higher concentrations of macrophage migration inhibitory factor in airways of extremely premature infants.
We measured macrophage migration inhibitory factor by enzyme linked immunosorbent assay in tracheobronchial aspirate fluid of 35 ventilated infants less than 30 weeks' gestational age, throughout the first week of life. Three groups were distinguished histologically: chorioamnionitis, funisitis, and control.
Unexpectedly, funisitis was associated with significantly decreased macrophage migration inhibitory factor in tracheobronchial aspirate fluid on day 1 (P < .01) and levels remained lower than in the chorioamnionitis group thereafter. For the 35 patients in total, macrophage migration inhibitory factor steadily declined.
Decreased macrophage migration inhibitory factor concentrations in airways of extremely premature infants with systemic fetal inflammation early in life might predispose them to pulmonary infection and interfere with maturation of the lung, contributing to adverse pulmonary outcome.
巨噬细胞移动抑制因子是先天性免疫的促炎介质，可促进细胞生长，并在早产中发挥作用。我们推测，反映胎儿全身炎症的脐带炎与极早早产儿气道中更高浓度的巨噬细胞移动抑制因子有关。
我们在35名孕周小于30周的机械通气婴儿出生后第一周内，通过酶联免疫吸附测定法测量了其气管支气管吸出液中的巨噬细胞移动抑制因子。根据组织学将其分为三组：绒毛膜羊膜炎组、脐带炎组和对照组。
出乎意料的是，脐带炎组在出生第1天时气管支气管吸出液中的巨噬细胞移动抑制因子显著降低（P <.01），且此后其水平一直低于绒毛膜羊膜炎组。在全部35例患者中，巨噬细胞移动抑制因子水平持续下降。
极早早产儿在生命早期出现全身性胎儿炎症时，其气道中巨噬细胞移动抑制因子浓度降低可能使其易患肺部感染，并干扰肺的成熟，从而导致不良的肺部结局。
