Chorioamnionitis and increased neonatal lung lavage fluid matrix metalloproteinase-9 levels: Implications for antenatal origins of chronic lung disease

被引:29
作者
Curley, AE
Sweet, DG
Thornton, CM
O'Hara, MD
Chesshyre, E
Pizzotti, J
Wilbourn, MS
Halliday, HL
Warner, JA
机构
[1] Queens Univ Belfast, Inst Clin Sci, Dept Child Hlth, Belfast, Antrim, North Ireland
[2] Royal Victoria Hosp, Dept Paediat Pathol, Belfast BT12 6BA, Antrim, North Ireland
[3] Univ Southampton, Sch Biol Sci, Southampton, Hants, England
关键词
preterm; antenatal corticosteroids; chorioamnionitis; matrix metalloproteinases; chronic lung disease;
D O I
10.1067/mob.2003.215
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Matrix metalloproteinase-9 (MMP-9) degrades type IV collagen, the major constituent of lung basement membrane. We studied the effects of chorioamnionitis and antenatal corticosteroids on bronchoalveolar lavage (BAL) fluid levels of MMP-9, and its inhibitor, TIMP-1 in preterm infants. STUDY DESIGN: A prospective study was performed on serial BAL samples from 79 ventilated preterm infants at less than 33 weeks' gestation, 18 of whom were. from pregnancies complicated by chorioamnionitis. MMP-9 levels were measured by gelatin zymography and TIMP-1 by enzyme-linked immunosorbent assay, and the median value for each infant was calculated. The presence and severity of chorioamnionitis were defined histologically. RESULTS: BAL fluid MMP-9 levels were higher in preterm infants in the chorioamnionitis group (86 [29-518] vs 13 [3-43] ng/mL, P=.001), and levels increased stepwise with the increasing severity of chorioamnionitis. Antenatal corticosteroids had no effect on median MMP-9 levels. Infants in the chorioamnionitis group were more likely to have chronic lung disease (CLD) develop (55% vs 28%, P <.05). TIMP-1 levels were no different between groups. CONCLUSION: Chorioamnionitis is associated with increased lung type IV collagenase levels in the ventilated preterm infant. Antenatal lung inflammation with up-regulation of MMP-9 may be important in the pathogenesis of CLD.
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页码:871 / 875
页数:5
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