NF-B in tracheal lavage fluid from intubated premature infants: Association with inflammation, oxygen and outcome

Abdelhamid Bourbia ¹, Mercedes A Cruz ¹ and Henry J. Rozycki ^1*

¹ School of Medicine, Virginia Commonwealth University, United States

^* To whom correspondence should be addressed. E-mail: hrozycki{at}hsc.vcu.edu.

Accepted 11 June 2005

Abstract

Objectives:To determine if tracheal lavage concentrations of the transcription factor NF-[kappa]kB, which is activated by risk factors associated with Bronchopulmonary Dysplasia (BPD), and induces expression of cytokines associated with BPD, is related to BPD in premature infants.

Design:Serial tracheal lavage samples from intubated premature infants were analyzed for cell count, IL-8 concentrations and nuclear NF-[kappa]B levels, corrected for dilution by SC concentrations.

Setting:Level III University hospital NICU.

Patients:33 intubated infants (mean birthweight 903 ± 258 g(± SD), median gestation 27 wk (range 24-31) in the first 14 days of life.

Main Outcome Measures:Tracheal effluent NF-[kappa] B, IL-8 and cell counts, corrected for dilution by secretory component measurement.

Results:Square root transformed NF-[kappa]B concentrations were significantly related to signs of inflammation (cell count p = 0.002, IL-8 p = 0.019) and to simultaneous FiO2 in samples from the first 3 days of life (r = 0.512, p < 0.003). Of the 32 subjects with samples in the first three days of life the half who either died or had BPD had higher NF-[kappa]B concentrations vs. the no BPD group (Square root concentration 0.097 ± 0.043 vs 0.062 ± 0.036 mcg/mcg protein/mcg SC, p = 0.018).

Conclusions:Tracheobronchial lavage NF-[kappa]B concentrations relate to lung inflammation and oxygen exposure and to pulmonary outcome in intubated preterm infants. NF-[kappa]B activation may be an early critical step leading to BPD.

Keywords: bronchopulmonary dysplasia, cytokines, lung injury, respiratory distress syndrome

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