L-selectin expression on polymorphonuclear leukocytes and monocytes in premature infants: Reduced expression after dexamethasone treatment for bronchopulmonary dysplasia,☆☆,

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Abstract

We examined the effect of dexamethasone on the expression of the adhesion molecule L-selectin on circulating polymorphonuclear leukocytes (PMLs) and monocytes from premature infants with bronchopulmonary dysplasia (BPD). Nineteen infants who received dexamethasone (Dex group) and 28 who did not receive dexamethasone (no Dex group) were studied. L-selectin expression, measured as mean fluorescence intensity, was lower on circulating PMLs (5.7 ± 0.6 vs 10.6 ± 0.7, p < 0.001) and monocytes (7.9 ± 0.9 vs 12.5 ± 0.9, p < 0.02) isolated from those who had received dexamethasone. Because L-selectin is important for the recruitment of PMLs to inflammatory foci in the lungs, we speculate that one of the mechanisms by which dexamethasone reduces inflammation in BPD is by impairing the ability of leukocytes to migrate into the BPD lesions. (J Pediatr 1998;132:53-6)

Section snippets

Patients

Premature infants who had or were at risk for BPD, admitted to the Special Care Nursery at British Columbia's Children's Hospital in Vancouver over a 16-week period, were entered into this study. The criteria for selecting patients were: (1) gestational age at birth of 28 weeks or less and (2) requirement for mechanical ventilation and oxygen therapy for at least 24 hours. Samples from infants with proven sepsis (positive blood cultures) or with a high clinical index of suspicion for sepsis

Patient Demographics and Sample Description

Nineteen infants who received dexamethasone (Dex group) and 28 who did not receive dexamethasone (no Dex group) were studied. A total of 196 samples were processed; nine samples were excluded from analysis because of sepsis. Birth weight, gestational age, and sex were not significantly different between the no Dex and Dex groups. According to oxygen dependency at 28 days of life, BPD was diagnosed in 57% of the control group and 79% of the Dex group. Chronologic age (age when sample was

Discussion

In this study we have shown that premature infants treated with dexamethasone have circulating PMLs that are increased in number and have decreased expression of L-selectin. This contrasts sharply with other stimuli causing marrow release where an increase in the leukocyte count is associated with elevated expression of L-selectin.11 Monocytes were also increased in number and had reduced L-selectin expression. L-selectin expression on leukocytes obtained from the cord blood of healthy newborn

Acknowledgements

We thank Ruth Milner and Lorri Verburgt for their advice and their contribution to the statistical analysis. We also thank the personnel of the Hematopathology Laboratory at Children's Hospital and the Immunology Laboratory at St Paul's Hospital for their assistance in the flow cytometric analysis.

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From the Department of Pediatrics and Department of Pathology, BC Children's Hospital; Pulmonary Research Laboratory and Department of Pathology and Laboratory Medicine, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. Supported in part by the British Columbia Lung Association, the Medical Research Council of Canada, and the South African Medical Research Council.

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Reprint requests: Gregory P. Bondy, MD, Pulmonary Research Laboratory, St. Paul's Hospital, 1081 Burrard St., Vancouver, BC, Canada V6Z 1Y6.

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