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Variations of protease inhibitors in foetuses, newborn infants and in some neonatal disorders
Insights
Infants with idiopathic respiratory distress syndrome (IRDS) show low levels of alpha-antitrypsin and antichymotrypsin on day one. These protease inhibitor levels normalize by day two in IRDS infants.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pulmonology
Background:
- Idiopathic respiratory distress syndrome (IRDS) is associated with low protease inhibitor levels.
- Protease inhibitors play a role in neonatal respiratory health.
Purpose of the Study:
- To investigate protease inhibitor concentrations in infants with IRDS.
- To compare these levels with those in foetuses and healthy infants.
Main Methods:
- Electroimmunoassay was used to measure alpha1-antitrypsin, antichymotrypsin, and alpha2-macroglobulin.
- Study included 19 IRDS infants, foetuses, and control term/preterm infants.
Main Results:
- IRDS infants had significantly lower alpha1-antitrypsin and antichymotrypsin on day 1, normalizing by day 2.
- Foetal protease inhibitor levels were lower than adult levels.
- Elevated protease inhibitors were observed in infants born after premature rupture of membranes.
Conclusions:
- Protease inhibitors may have a role in IRDS pathogenesis.
- Potential roles include hyaline membrane dissolution and protection against pulmonary injury.
- Further research is needed to fully understand the function of protease inhibitors in IRDS.
Abstract:
Low levels of protease inhibitors have been found on the 1st day of life in IRDS infants. 19 IRDS infants were studied together with foetuses and control term and preterm infants. Alpha1-antitrypsin, antichymotrypsin and alpha2-macroglobulin were measured with the electroimmuno assay. IRDS infants had significantly reduced concentration of alpha-antitrypsin and antichymotrypsin on the 1st day, the level increasing to normal on the 2nd day. In foetuses alpha1-antitrypsin was normal, antichymotrypsin 2% and alpha2-macroglobulin 1/3 of the normal adult level. The protease inhibitors are increased in infants born after premature rupture of foetal membranes. The part, if any, played by protease inhibitors is not entirely understood. The inhibitors may, theoretically, be of some importance in the dissolution of the hyaline membranes, protect against pulmonary vasoconstriction, protect pulmonary tissue against leucocyte and macrophage proteolytic enzymes and inhibit the release of or counteract vasoactive substances that might take part in the development of shock in IRDS babies.