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Decreased interleukin-10 in tracheal aspirates from preterm infants developing chronic lung disease
1School of Women's and Children's Health, The University of New South Wales, Randwick, Australia.
Insights
Preterm infants at risk for chronic lung disease (CLD) may have lower levels of the anti-inflammatory cytokine interleukin-10 (IL-10). Reduced IL-10 production, influenced by gestational age, could predispose infants to persistent lung inflammation.
Area of Science:
- Neonatal Medicine
- Pulmonology
- Immunology
Background:
- Chronic lung disease (CLD) in preterm infants arises from an imbalance between lung injury and healing.
- Interleukin-10 (IL-10), an anti-inflammatory cytokine, is thought to play a role in this process.
- IL-10 production may be influenced by gestational age, potentially impacting CLD susceptibility.
Purpose of the Study:
- To investigate the association between interleukin-10 (IL-10) levels in tracheal fluid (TF) and the development of chronic lung disease (CLD) in preterm infants.
- To determine if gestational age influences IL-10 production in infants at risk for CLD.
Main Methods:
- Tracheal fluid (TF) samples were collected from 48 mechanically ventilated infants within the first week of life.
- IL-10 levels were measured in TF specimens and correlated with the development of CLD.
- IL-8 levels were also analyzed for comparison.
Main Results:
- Infants who developed CLD had significantly lower TF IL-10 levels compared to non-CLD preterm infants.
- Higher gestational age was associated with increased TF IL-10 levels.
- TF IL-10 levels were not influenced by hyaline membrane disease, antenatal steroids, or TF sample volume.
Conclusions:
- A gestationally influenced reduction in IL-10 production may predispose preterm infants to persistent pulmonary inflammation characteristic of CLD.
- Monitoring IL-10 levels could potentially identify infants at higher risk for developing CLD.
Unlabelled:
The inability to balance pulmonary injury with healing may predispose preterm infants to chronic lung disease (CLD). It is postulated that the production of interleukin (IL)-10, an anti-inflammatory cytokine, is gestationally influenced and that CLD-prone infants may have a reduced ability to produce IL-10.
Methods:
Tracheal fluid (TF) was collected at least twice weekly from 48 mechanically ventilated infants within the first 7 d of life while intubated.
Results:
A total of 87 TF specimens were obtained. None of the 11 CLD infants (24-31 wk of gestation) had TF IL-10 levels above 4 pg/ml (0/20 TF specimens), while 14 (70%) of the 20 non-CLD preterm infants (27-36 wk of gestation) had IL-10 levels above 5 pg/ml in one or more of their TF specimens (18/48 TF specimens, p < 0.001). Only the 5 term infants who were ventilated for severe lung disease had raised IL-10 levels (17 infants, 5/19 TF specimens). IL-10 levels, if detected, (range 6-938 pg/ml) tended to be higher with increasing gestation (Spearman's rho coefficient = 0.43; p = 0.003). TF IL-10 detection was not associated with hyaline membrane disease, antenatal steroids or influenced by TF sample volume. Overall IL-8 levels were wide ranging but towards the end of week 1 the levels were significantly higher in CLD infants (CLD: median 34 184 ng/ml, preterm non-CLD: median 699 ng/ml, p < 0.001, term: 2961 ng/ml, p = 0.028).
Conclusion:
A gestationally influenced low IL-10 may predispose preterm infants to persistent pulmonary inflammation of CLD.