The role of inflammation in the development of chronic lung disease in neonates

Citation
Jj. De Dooy et al., The role of inflammation in the development of chronic lung disease in neonates, EUR J PED, 160(8), 2001, pp. 457-463
Citations number
53
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
EUROPEAN JOURNAL OF PEDIATRICS
ISSN journal
0340-6199 → ACNP
Volume
160
Issue
8
Year of publication
2001
Pages
457 - 463
Database
ISI
SICI code
0340-6199(200108)160:8<457:TROIIT>2.0.ZU;2-G
Abstract
Chronic lung disease (CLD) has been associated with chorioamnionitis and up per respiratory tract colonisation with Ureaplasma urealyticum. The aim of this review is to describe the increasing evidence that inflammation plays a critical role in the early stages of CLD of the neonate. Ongoing lung dam age in the premature infant may be caused by failure to downregulate and co ntrol this inflammatory response. Tumour necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6) and IL-8 are important pro-inflammatory cytokines of which IL-8 is an important chemotactic factor in the lung. Data suggest tha t preterm newborns with lung inflammation may be unable to activate the ant iinflammatory cytokine IL-10. Therefore, early post-natal anti-inflammatory therapy could help in preventing development of CLD. Prophylactic dexameth asone therapy cannot yet be recommended. There are a number of potential in teractions between surfactant and cytokine effects on the preterm lung whic h have not been evaluated. Surfactant protein A may be an important modulat or of the immune response to lung injury. The role of high-frequency ventil ation in the prevention of CLD still remains unclear. Conclusion Many aspects of the pathogenesis of the inflammatory response in the development of chronic lung disease remain to be elucidated. Further r esearch to identify preterm infants at highest risk for the development of this multifactorial and complex disease is needed.