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Dexamethasone therapy is associated with a rise in urinary epidermal growth factor concentrations in the preterm
S M Scott1, C Rogers, C Backstrom
1Department of Pediatrics, Children's Hospital of New Mexico, University of New Mexico, School of Medicine, Albuquerque.
Insights
Dexamethasone treatment increased urinary epidermal growth factor (EGF) in premature infants with chronic lung disease. This suggests EGF may indicate dexamethasone
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Biochemistry
Background:
- Glucocorticoid hormones, like dexamethasone, are used in premature infants for conditions such as airway edema and chronic lung disease.
- The impact of dexamethasone on epidermal growth factor (EGF) levels in premature infants remains largely undescribed.
- Understanding this relationship is crucial for optimizing treatment protocols and monitoring infant recovery.
Purpose of the Study:
- To investigate the effect of dexamethasone on urinary epidermal growth factor (EGF) concentrations in premature infants.
- To determine if EGF levels correlate with treatment outcomes, specifically recovery from ventilatory support.
Main Methods:
- Urinary samples were collected from 45 premature infants (25 for airway edema, 20 for chronic lung disease) before, during, and after dexamethasone therapy.
- Dexamethasone was administered for short-term airway edema or a six-week tapering protocol for chronic lung disease.
- Urinary EGF concentrations were measured and compared across different treatment phases and patient groups.
Main Results:
- Dexamethasone treatment did not alter EGF values in infants with airway edema.
- Infants treated for chronic lung disease showed increased urinary EGF values within one week of therapy.
- Infants who successfully recovered from ventilatory support had significantly higher post-therapy EGF levels compared to pre-therapy levels.
Conclusions:
- Dexamethasone therapy is associated with increased urinary EGF levels in premature infants receiving treatment for at least one week, particularly those with chronic lung disease.
- The observed increase in EGF, especially in infants recovering from ventilatory support, suggests EGF may serve as a biomarker for dexamethasone's therapeutic effects or a mediator of its action.
- Further research is warranted to elucidate the precise role of EGF in dexamethasone's mechanism of action and its potential as a clinical indicator in neonatology.
Abstract:
The effect of glucocorticoid hormones on epidermal growth factor (EGF) concentrations has not been described in the premature infant. We examined this relationship in a group of infants treated with dexamethasone for airway edema (three to five doses) or chronic lung disease (six weeks of a tapering protocol). We collected urinary samples in 45 infants (25 for airway edema, 20 for chronic lung disease) before, during and after the use of dexamethasone. The EGF values were unchanged in infants that were given dexamethasone for airway edema. In contrast, all infants treated for chronic lung disease increased their EGF values by 1 week of therapy. At the end of the dexamethasone taper, ten of the infants had recovered successfully from ventilatory support. This group of infants had post-therapy EGF values that were significantly higher than pretherapy values. In the ten infants that were still ventilator dependent at the end of therapy, EGF values were not different from pretherapy values. We conclude that dexamethasone therapy was associated with an increase in urinary EGF values in the preterm infant treated for at least 1 week. The positive correlation of tapering from ventilatory support with increases in EGF values suggests that EGF may be a marker of dexamethasone effect or an effector of dexamethasone action.