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Chorioamnionitis and increased neonatal lung lavage fluid matrix metalloproteinase-9 levels: implications for antenatal origins of chronic lung disease
Published in:
Am J Obstet Gynecol, Vol: 188, Page: 871-5
Publication Date:
April 2003
Aims & Objectives:
The aim of this study was to examine the effects of chorioamnionitis and antenatal corticosteroids on bronchoalveolar lavage fluid levels of MMP-9, and its inhibitor, TIMP-1 in preterm infants.
Abstract:
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.
Authors:
Study Type:
Study Papers » Case Study » Descriptive Studies - Without a comparision
Categories:
chorioamnionitis; antenatal corticosteroids
International Classification:
Pregnancy, childbirth and the peurperium - chorioamnionitis
Keywords:
- Bronchoalveolar Lavage Fluid/ chemistry
- Chorioamnionitis/complications/ physiopathology
- Chronic Disease
- Female
- Humans
- Infant, Newborn, Diseases/embryology/enzymology/etiology
- Infant, Newborn/ metabolism
- Lung Diseases/embryology/enzymology/etiology
- Lung/ enzymology
- Matrix Metalloproteinase 9/ metabolism
- Pregnancy
- Prospective Studies
Geography:
Northern Ireland (Northern Ireland)