Department of Neonatology, Osaka City General Hospital, Osaka, Japan.
Neonatology. 2009;96(3):156-61. doi: 10.1159/000210088. Epub 2009 Mar 31.
Chorioamnionitis (CAM) can initiate fetal lung injury resulting in neonatal bronchopulmonary dysplasia (BPD). While neonates with BPD have higher amniotic fluid concentrations of proinflammatory cytokines, overexpression of transforming growth factor (TGF)-beta(1) also appears important in the pathogenesis of BPD. The aim of this study was to investigate the relationship between TGF-beta(1) and CAM-induced fetal lung injury. Forty-four amniotic fluid samples were obtained at delivery of preterm infants (median gestation, 28 weeks; birth weight, 908 g). TGF-beta(1) and interleukin (IL)-6 concentrations in the amniotic fluid were measured with ELISA. Both TGF-beta(1) and IL-6 concentrations in the amniotic fluid increased with increasing histological severity of CAM (each p < 0.0001). The presence of both BPD and histological CAM was associated with significantly higher amniotic fluid TGF-beta(1) and IL-6 concentrations than the presence of BPD without histological CAM, or the absence of both (each p < 0.0001). Both concentrations also correlated with the duration of oxygen administration in the neonates (each p < 0.0001). Amniotic fluid TGF-beta(1) seems to be important in CAM-induced fetal lung injury progressing to neonatal BPD.
绒毛膜羊膜炎(CAM)可引发胎儿肺损伤,导致新生儿支气管肺发育不良(BPD)。虽然患有 BPD 的新生儿羊水中促炎细胞因子浓度较高,但转化生长因子-β1(TGF-β1)的过度表达似乎在 BPD 的发病机制中也很重要。本研究旨在探讨 TGF-β1 与 CAM 诱导的胎儿肺损伤之间的关系。在早产儿分娩时获得 44 份羊水样本(中位孕龄 28 周;出生体重 908g)。采用 ELISA 法测定羊水中 TGF-β1 和白细胞介素-6(IL-6)的浓度。羊水中 TGF-β1 和 IL-6 的浓度均随 CAM 组织学严重程度的增加而增加(均 p<0.0001)。BPD 和组织学 CAM 均存在时,羊水中 TGF-β1 和 IL-6 的浓度明显高于仅存在 BPD 而无组织学 CAM 时,或两者均不存在时(均 p<0.0001)。两种浓度均与新生儿吸氧时间呈正相关(均 p<0.0001)。羊水中 TGF-β1 似乎在 CAM 诱导的胎儿肺损伤进展为新生儿 BPD 中起重要作用。