Angiopoietin 2 concentrations in infants developing bronchopulmonary dysplasia: attenuation by dexamethasone

Objectives: To study the association between angiopoietin 2 (Ang2) concentrations in tracheal aspirates (TAs) and adverse outcome (bronchopulmonary dysplasia (BPD)/death) in ventilated premature infants (VPIs) and modulation of Ang2 concentrations with dexamethasone (Dex) use. Study Design: Serial TA samples were collected on days 1, 3, 5 and 7, and Ang2 concentrations were measured. Ang2 TA concentrations were compared prior to and after 48 to 72h Of using DeX. Result: A total of 151 TA samples were collected from 60 VPIs. BPD was defined as the oxygen requirement at 36 weeks postmenstrual age (PMA) Twelve infants (mean +/- s.d.) (gestational age (GA) 26.5 +/- 2.1 weeks, birth weight (BW) 913 +/- 230 g) had no BPD, 32 infanLs (GA 25.8 +/- 1.4 0 weeks, BW 768 +/- 157 g) developed BPD and 16 infants (GA 24.5 +/- 1.1 weeks, BW 710 143 g) died before 36 weeks PMA. Ang2 concentrations were significantly lower in infants with no BPD (median, 25th and 75th percentile) G 57, 16 and 218 pg mg(-1)) compared with those who developed BPD (234, 138 and 338 pg mg(-1), P = 0.03) or BPD and/or death (234, 157 and 347 pg mg(-1), P = 0.017), in the first week of life. Twenty-six VPIs (BW 719 +/- 136 g CA 25.1 +/- 1.3 weeks) received 27 Courses of Dex. Ang2 concentrations before starting Dex were 202, 137 and 278 pg mg(-1) and significantly decreased to 144, 0 and 224 pg mg(-1) after therapy (P = 0.007). Conclusions: Higher Ang2 concentrations in TAs are associated with the development of BPD or death in VPIs. Dex use suppressed Ang2 concentrations.