ORIGINAL ARTICLE

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

A Bourbia, M A Cruz and H J Rozycki

Virginia Commonwealth University, Richmond, VA 23298-0276, USA

Correspondence to:
Correspondence to:
Dr Rozycki
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298-0276, USA; hrozycki{at}hsc.vcu.edu

Objectives: To determine if tracheal lavage concentrations of the transcription factor NF-B, 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 analysed for cell count and concentrations of interleukin (IL)8 and NF-B, corrected for dilution by secretory component concentrations.

Setting: Level III university hospital neonatal intensive care unit.

Patients: Thirty three intubated infants (mean (SD) birth weight 903 (258) g, median gestation 27 weeks (range 24–31)) in the first 14 days of life.

Main outcome measures: Tracheal effluent NF-B, IL8, and cell counts, corrected for dilution by secretory component measurement.

Results: Square root transformed NF-B concentrations were significantly related to signs of inflammation (cell count, p = 0.002; IL8, p = 0.019) and to simultaneous fraction of inspired oxygen in samples from the first 3 days of life (r = 0.512, p<0.003). Of the 32 subjects with samples in the first 3 days of life, the half who either died or had BPD had higher NF-B concentrations than those without BPD (square root concentration 0.097 (0.043) v 0.062 (0.036) µg/µg protein/µg secretory component, p = 0.018).

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

Abbreviations: BPD, bronchopulmonary dysplasia; FIO₂, fraction of inspired oxygen; IL, interleukin; NF-B, nuclear factor-kappa B; SC, secretory component

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

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