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Ascorbate acid concentration in airways lining fluid from infants who develop chronic lung disease of prematurity
J R Vyas1, A Currie, C Dunster
1Department of Child Health, University of Leicester, Leicester Royal Infirmary, UK.
Insights
Infants developing chronic lung disease of prematurity (CLD) show a delayed increase in bronchoalveolar lavage fluid (BALF) ascorbate. This antioxidant difference may indicate an increased risk for CLD in preterm infants.
Area of Science:
- Neonatology
- Pulmonology
- Biochemistry
Background:
- Chronic lung disease of prematurity (CLD) is a significant cause of infant morbidity and mortality.
- Oxygen toxicity is a key risk factor for CLD, highlighting the importance of antioxidant status in affected infants.
Purpose of the Study:
- To investigate if ascorbate, urate, and glutathione concentrations are decreased in preterm infants who develop CLD compared to those who do not.
- To assess the temporal changes in these antioxidants in bronchoalveolar lavage fluid (BALF) and plasma.
Main Methods:
- Serial BALF and plasma samples were collected from 34 preterm infants categorized into CLD, respiratory distress syndrome (RDS), and control groups.
- Concentrations of ascorbate, urate, and total glutathione were measured in these samples over the first two weeks of life.
Main Results:
- BALF ascorbate, urate, and glutathione decreased in all groups during the first week post-birth.
- While BALF ascorbate increased in RDS and control infants in the second week, this rise was delayed by two weeks in infants who developed CLD.
- No significant differences in BALF urate, total glutathione, or plasma urate were observed between CLD and RDS groups.
Conclusions:
- A delayed increase in BALF ascorbate concentration may be associated with an elevated risk of developing chronic lung disease of prematurity.
- Ascorbate levels could serve as a potential biomarker for predicting CLD risk in preterm neonates.
Abstract:
Chronic lung disease of prematurity (CLD) remains a common cause of morbidity and mortality in preterm infants. Oxygen toxicity remains a major risk factor for the development of CLD and as a consequence the antioxidant status of CLD babies is a major focus of interest. In the present study, we determined whether ascorbate, urate, and total glutathione concentrations were decreased in infants who developed CLD when compared to those who did not. From 34 preterm infants, 141 serial bronchoalveolar lavage fluid (BALF) and plasma samples were collected: 12 developed CLD (median gestation 26 weeks, range 23-28 weeks, median birth weight 780 g, range 630-1070 g), 16 developed and recovered from respiratory distress syndrome (RDS) (median gestation 31 weeks, range 26-39 weeks, median birth weight 1820 g, range 840-4160 g), and six were ventilated for non-respiratory reasons, (median gestation 35 weeks, range 32-38 weeks, median birth weight 2180 g, range 1100-2860 g). Following birth, the concentration of BALF ascorbate, urate and glutathione decreased over the 1st week in all three groups. Thereafter, BALF ascorbate increased in RDS and control infants during the 2nd week but this increase was delayed by 2 weeks in the CLD infants. No differences were noted between the RDS and CLD groups for urate and total glutathione in BALF or urate in plasma. BALF protein concentration was similar in all three groups except for a rise at day 7 in the CLD group but this did not reach statistical significance. Conclusion. A delayed increase in bronchoalveolar lavage fluid ascorbate concentration might be associated with an increased risk of developing chronic lung disease of prematurity.