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Published on: August 7, 2017
Effects of postnatal hydrocortisone on cytokine profile in extremely preterm infants
Kentaro Tamura1, Mitsuhide Nagaoka1, Satomi Inomata1
1Division of Neonatology, Maternal and Perinatal Center, Toyama University Hospital, Toyama, Japan.
Insights
Systemic hydrocortisone in preterm infants did not prevent bronchopulmonary dysplasia (BPD), but it may suppress interleukin-6 (IL-6) overproduction. This study examined cytokine profiles in extremely preterm infants receiving hydrocortisone.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Immunology
Background:
- Systemic hydrocortisone is used in preterm infants at risk for bronchopulmonary dysplasia (BPD).
- The impact of hydrocortisone on cytokine profiles in this population is not well understood.
- Investigating these effects is crucial for optimizing treatment strategies.
Purpose of the Study:
- To examine the effects of postnatal hydrocortisone treatment on serum cytokine levels in extremely preterm infants.
- To compare cytokine profiles between infants who received hydrocortisone and those who did not.
- To assess the relationship between hydrocortisone use and BPD development.
Main Methods:
- Retrospective study of 29 infants born before 28 weeks gestational age.
- Serum cytokine levels measured in early (5-20 days) and late (28-60 days) phases.
- Analyzed proinflammatory, Th1, Th2, Th17 cytokines, and chemokines, comparing steroid vs. non-steroid groups.
Main Results:
- 45% of infants received hydrocortisone for respiratory deterioration.
- BPD incidence was higher in the hydrocortisone group (P=0.008).
- Hydrocortisone group showed a significantly lower late-to-early phase ratio of IL-6 (P=0.04); other cytokines were unchanged.
Conclusions:
- Postnatal hydrocortisone for respiratory issues did not prevent BPD in this cohort.
- Hydrocortisone treatment may suppress interleukin-6 (IL-6) overproduction in extremely preterm infants.
- Further research is needed to clarify hydrocortisone's role in neonatal inflammatory responses.
Background:
Systemic hydrocortisone administration has been widely used in preterm infants who are at risk of bronchopulmonary dysplasia (BPD). However, the effects of hydrocortisone on cytokine profiles have not been examined. We aimed to investigate the effects of postnatal hydrocortisone treatment on serum cytokine levels in extremely preterm infants.
Methods:
This is a retrospective study of 29 extremely preterm infants born at <28 weeks of gestational age. We obtained serum from blood samples collected during an early phase (5-20 days) and a late phase (28-60 days) after birth. We measured the levels of proinflammatory cytokines (tumor necrosis factors α and β, interleukin (IL)-1β, and IL-6), T-helper (Th) 1 cytokines (interferon-γ, IL-2, and IL-12p70), Th2 cytokines (IL-4, IL-5, and IL-10), Th17 cytokine IL-17A, and chemokine IL-8. The cytokine levels between the early and late phases were compared between infants who received postnatal hydrocortisone and those who did not.
Results:
Thirteen infants (45%) received systemic hydrocortisone treatment at a median age of 15 days (IQR: 10.0-21.5) after birth due to respiratory deterioration. The percentage of BPD was higher in the steroid group than in the non-steroid group (P = 0.008). The ratio of IL-6 for the late-to-early phase was significantly lower in the steroid group than in the non-steroid group (P = 0.04). The concentration of the other cytokines remained unchanged between the phases.
Conclusions:
Although the postnatal hydrocortisone treatment provided for respiratory deterioration did not prevent the BPD development, hydrocortisone treatment might suppress IL-6 overproduction in extremely preterm infants.
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