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Vascular endothelial growth factor in pulmonary lavage fluid from premature infants: effects of age and postnatal
C T D'Angio1, W M Maniscalco, R M Ryan
1Department of Pediatrics (Neonatology), Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. carl_dangio@urmc.rochester.edu
Insights
Dexamethasone (DEX) treatment in premature infants may temporarily increase vascular endothelial growth factor (VEGF) levels, potentially impacting lung development. These changes were not linked to bronchopulmonary dysplasia (BPD) development.
Area of Science:
- Neonatal physiology
- Pulmonary medicine
- Developmental biology
Background:
- Corticosteroids, like dexamethasone (DEX), are used to manage bronchopulmonary dysplasia (BPD) in preterm infants.
- These steroids can influence normal development and alter growth factor expression, including vascular endothelial growth factor (VEGF).
Purpose of the Study:
- To investigate the effect of prophylactic dexamethasone (DEX) on vascular endothelial growth factor (VEGF) levels in preterm infants.
- To explore the relationship between VEGF levels, gestational age, and the development of bronchopulmonary dysplasia (BPD).
Main Methods:
- A randomized controlled trial involving 40 infants (<34 weeks gestation) receiving either DEX or a placebo for BPD prophylaxis.
- Deep pulmonary lavage specimens were collected on days 1, 3, 7, and 28 of life.
- VEGF levels were quantified using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Pulmonary lavage VEGF levels significantly increased from day 1 to day 3 in both DEX and control groups.
- VEGF levels were higher in the DEX group on day 7 but normalized by day 28.
- Higher early VEGF levels (days 1-3) correlated with lower gestational age.
- VEGF levels were not associated with the incidence or severity of BPD.
Conclusions:
- Dexamethasone administration transiently alters pulmonary VEGF levels in preterm infants.
- These DEX- and age-associated VEGF changes may play a role in pulmonary angiogenesis.
- Further research is needed to understand the long-term implications of these findings on lung development.
Abstract:
Corticosteroids are used to ameliorate bronchopulmonary dysplasia (BPD). They also affect normal development, including the expression of growth factors such as vascular endothelial growth factor (VEGF). Deep pulmonary lavage specimens were collected on days 1, 3, 7 and 28 of life in 40 infants of <34 weeks of gestation at birth during a randomized controlled trial of two doses of dexamethasone (DEX) at 12 and 24 h of age for BPD prophylaxis. VEGF was measured by enzyme-linked immunosorbent assay. The 18 DEX and 21 control subjects had similar gestations, birth weights and oxygen requirements at study entry. Lavage VEGF tripled between day 1 and 3 in both groups. The day 7 levels were higher in DEX subjects than in controls. DEX and control values were similar on day 28. Higher lavage VEGF levels on days 1 and 3 were also correlated with lower gestational age at birth. Lavage VEGF levels were not associated with the development of BPD. We speculate that these DEX- and age-associated changes in VEGF may affect pulmonary angiogenesis.
