Departments of Pathology, University of Otago Christchurch, Christchurch 8140, New Zealand.
Pediatr Res. 2011 Jan;69(1):28-33. doi: 10.1203/PDR.0b013e3181ff2378.
Bronchopulmonary dysplasia is associated with neutrophil infiltration into the lungs and oxidative injury. However, the pathological importance of neutrophil oxidants is still not clear. Nosocomial pneumonia is also implicated, but the evidence is limited, in part because of the difficulty of distinguishing genuine infection from bacterial colonization. Good biomarkers of neutrophil oxidant activity and lung infection are needed. We tested whether glutathione sulfonamide, a product of glutathione oxidation by myeloperoxidase-derived hypochlorous acid (HOCl) and a potential new neutrophil oxidant biomarker, is detectable in endotracheal aspirates from ventilated preterm infants. As infectious organisms stimulate neutrophils to generate HOCl, we determined whether levels of HOCl-specific biomarkers were increased in samples that were bacterial culture positive. Glutathione sulfonamide was detected in 66 of 87 endotracheal aspirate samples. Levels correlated with myeloperoxidase activity and another HOCl-specific marker, chlorotyrosine. Median levels of glutathione sulfonamide (4-fold) and other biomarkers (2-fold) were significantly higher in culture positive aspirates. Staphylococcus epidermidis, a frequent colonizer, was associated with glutathione sulfonamide levels no different from those in negative samples. Glutathione sulfonamide showed good sensitivity and specificity for detecting bacterial growth and has promise for detecting lung infection.
支气管肺发育不良与中性粒细胞浸润肺部和氧化损伤有关。然而，中性粒细胞氧化剂的病理重要性仍不清楚。医院获得性肺炎也与此相关，但证据有限，部分原因是难以区分真正的感染与细菌定植。需要有良好的中性粒细胞氧化剂活性和肺部感染的生物标志物。我们检测了谷胱甘肽磺酰胺（由髓过氧化物酶衍生的次氯酸（HOCl）氧化谷胱甘肽产生的产物）是否可以在机械通气的早产儿的气管内吸出物中检测到。由于感染性生物体会刺激中性粒细胞产生 HOCl，我们确定了在细菌培养阳性的样本中，HOCl 特异性生物标志物的水平是否增加。在 87 个气管内吸出物样本中的 66 个样本中检测到谷胱甘肽磺酰胺。水平与髓过氧化物酶活性和另一种 HOCl 特异性标志物氯酪氨酸相关。谷胱甘肽磺酰胺（4 倍）和其他生物标志物（2 倍）的中位数水平在培养阳性的吸出物中明显更高。表皮葡萄球菌是一种常见的定植菌，其谷胱甘肽磺酰胺水平与阴性样本无差异。谷胱甘肽磺酰胺在检测细菌生长方面具有良好的敏感性和特异性，有望用于检测肺部感染。
