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Epidermal growth factor in the lungs of infants developing chronic lung disease
A E Currie1, J R Vyas, J MacDonald
1Dept of Child Health, University of Leicester, UK.
Insights
Epidermal growth factor (EGF) levels in premature infants are linked to gestational age. Lower EGF concentrations at birth may predispose infants to chronic lung disease (CLD).
Area of Science:
- Neonatal Medicine
- Pulmonology
- Biochemistry
Background:
- Chronic lung disease (CLD) of prematurity impacts lung development.
- Growth factors like epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) play roles in lung growth and angiogenesis.
- Their role in CLD pathogenesis is not well understood.
Purpose of the Study:
- To investigate the concentrations of EGF and VEGF in bronchoalveolar lavage fluid (BALF) of preterm infants.
- To determine the relationship between these growth factors, gestational age, and the development of CLD or respiratory distress syndrome (RDS).
Main Methods:
- Analysis of 111 BALF samples from 35 ventilated infants.
- Infants were categorized into three groups: developed CLD, developed and recovered from RDS, and controls.
- EGF and VEGF concentrations were measured at birth and over time.
Main Results:
- At birth, EGF levels were significantly lower in infants who developed CLD and RDS compared to controls.
- BALF EGF concentrations showed a strong positive correlation with gestational age (R=0.73).
- VEGF was undetectable at birth but increased similarly in all groups, without correlation to gestation.
Conclusions:
- EGF levels are closely correlated with gestational age in preterm infants.
- Lower EGF concentrations at birth may be a risk factor for developing CLD.
- These findings suggest a potential role for EGF in the pathogenesis of CLD in prematurity.
Abstract:
Growth factors important to lung growth and fibrosis have been poorly studied in chronic lung disease (CLD) of prematurity. Epidermal growth factor (EGF) promotes epithelial cell maturation, and vascular endothelial growth factor (VEGF) is important in angiogenesis. The concentration of these growth factors was determined in 111 bronchoalveolar lavage fluid (BALF) samples from 35 ventilated infants: 13 developed CLD (median gestation 27 weeks, birthweight 820 g), 16 developed and recovered from respiratory distress syndrome (RDS) (31 weeks, 1,415 g) and six control infants (33 weeks, 2,075 g) were ventilated for nonpulmonary reasons. At birth, EGF in BALF from the CLD and RDS infants was lower than in the control infants (control versus CLD, 7.3 versus 0.0 pg x mL(-1), p<0.01; control versus RDS, 7.3 versus 5.0, p=0.08). EGF increased in all groups with a more rapid increase in control infants. A close relationship was noted between BALF EGF and gestational age (R=0.73). VEGF was undetectable at birth but increased at a similar rate in all three groups and did not correlate with gestation. In conclusion, these data suggest that epidermal growth factor is closely correlated to gestation and that it may predispose preterm infants to develop chronic lung disease.