EFFECTS OF DEXAMETHASONE (DXM) ON CHEMOTACTIC ACTIVITY AND INFLAMMATORY INDICATORS IN TRACHEAL ASPIRATES OF PRETERM INFANTS AT RISK FOR CHRONIC LUNG DISEASE (CLD)

摘要

To evaluate the effect of Dxm on the inflammatory process in the early phase of CLD (postnatal age 10-16 days), tracheal aspirate fluid (TAF) from 16 preterm infants (BW 891 ± 46 gms, GA 27.1 ± 0.4 wks, mean ± SEM) was assessed for chemotactic activity and indicators of inflammation. After Dxm therapy chemotactic response of blood neutrophils exposed to TAF decreased (migratory distance before Dxm 150 ±10um, after Dxm 91 ±11μm, p<0.001); additionally the influx of TAF-neutrophils was reduced (before Dxm 492 ±165 cells/μl effluent, after Dxm 77 ± 22, p<0.01) Elastase-alpha-1-Proteinaseinhibitor(a-1-PI)- complex decreased after treatment (before Dxm 534 ± 154, after Dxm 65 ±18 ng /ml, p<0.01). Before Dxm, free elastolytic activity was only present in one infant, 15/16 had a protective activity of a-1-PI. Concentrations of albumine were lower after Dxm(before Dxm 29 ±6, after Dxm 7 ±1 mg/dl, p<0.001), Interleukin-1 similary decreased. The reported effects could not be observed in untreated control infants (n=8). We conclude that Dxm reduces the pulmonary inflammatory reaction of preterm infants during the early phase of CLDSupported by a grant of Deutsche ForachungegemeinBchaft (Sp 239/3-1).