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Chorioamnionitis increases matrix metalloproteinase-8 concentrations in bronchoalveolar lavage fluid from preterm
A E Curley1, D G Sweet, K J MacMahon
1Department of Child Health, Queen's University Belfast, and the Regional Neonatal Unit, Royal Maternity Hospital, Belfast, Northern Ireland.
Insights
Chorioamnionitis, an infection during pregnancy, significantly increases matrix metalloproteinase-8 (MMP-8) levels in preterm infants. These elevated MMP-8 levels may contribute to lung injury in premature newborns.
Area of Science:
- Neonatal Medicine
- Pulmonology
- Biochemistry
Background:
- Preterm birth complications pose significant risks to infant health.
- Lung injury is a major concern in preterm infants, particularly those with respiratory distress syndrome.
- Matrix metalloproteinases (MMPs) are implicated in tissue remodeling and degradation, potentially playing a role in lung injury.
Purpose of the Study:
- To investigate the impact of chorioamnionitis and antenatal corticosteroids on matrix metalloproteinase-8 (MMP-8) levels in preterm infants.
- To assess the relationship between MMP-8 concentrations in bronchoalveolar lavage (BAL) fluid and the presence of chorioamnionitis.
- To evaluate the effect of antenatal corticosteroid treatment on MMP-8 levels in this vulnerable population.
Main Methods:
- A prospective observational study was conducted in a regional neonatal intensive care unit.
- Bronchoalveolar lavage (BAL) fluid was collected serially from 35 ventilated preterm infants (< 33 weeks gestation) within the first six postnatal days.
- Matrix metalloproteinase-8 (MMP-8) concentrations were quantified using enzyme-linked immunosorbent assay (ELISA), with median concentrations calculated per infant.
Main Results:
- Infants born following chorioamnionitis exhibited significantly higher median MMP-8 concentrations in BAL fluid compared to those without (43 ng/ml vs. 5 ng/ml).
- Antenatal corticosteroid administration, whether partial or complete, did not demonstrate a significant effect on MMP-8 levels.
- Histological diagnosis confirmed chorioamnionitis by the presence of inflammatory cells in the chorioamnionic plate.
Conclusions:
- Elevated MMP-8 levels in BAL fluid are associated with chorioamnionitis in preterm infants.
- MMP-8, a type I collagenase, may play a role in the pathogenesis of lung injury observed in preterm infants with respiratory distress syndrome.
- Further research is warranted to explore therapeutic strategies targeting MMP-8 to mitigate lung injury in preterm neonates.
Objective:
To determine the effects of chorioamnionitis and antenatal corticosteroids on matrix metalloproteinase-8 (MMP-8) concentrations in bronchoalveolar lavage (BAL) fluid from preterm babies in the first week of life.
Design:
Prospective observational study.
Setting:
Regional neonatal intensive care unit.
Patients:
Thirty five ventilated preterm babies < 33 weeks gestation, seven of whom were born after chorioamnionitis, which was diagnosed histologically as the presence of inflammatory cells in the chorioamnionic plate.
Methods:
MMP-8 was measured by enzyme linked immunosorbent assay (ELISA) in 90 serial BAL samples taken during the first six postnatal days. The median MMP-8 concentration for each baby was calculated.
Results:
Median MMP-8 concentrations were higher in the chorioamnionitis group than in those without (43 v 5 ng/ml). Partial or complete courses of antenatal corticosteroids had no effect on MMP-8 concentrations.
Conclusions:
Higher concentrations of MMP-8 are found in BAL fluid from preterm babies from pregnancies complicated by chorioamnionitis. This type I collagenase may contribute to the lung injury that occurs in some babies with respiratory distress syndrome.
