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PEDIATRICS Vol. 111 No. 3 March 2003, pp. 461-468

Soluble E-Selectin, Soluble L-Selectin and Soluble ICAM-1 in Bronchopulmonary Dysplasia, and Changes With Dexamethasone

Praveen Ballabh, MD*, Jaishree Kumari, MD*,{ddagger},§, Alfred N. Krauss, MD*, Junghee J. Shin, BS{ddagger}, Ajey Jain, MD*, Peter A. M. Auld, MD*, Martin L. Lesser§ and Susanna Cunningham-Rundles, PhD{ddagger}

* Departments of Neonatology
{ddagger} Hematology/Oncology/Immunology
§ Medical Statistics, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York

--> Objective. To evaluate longitudinal change in arterial blood plasma levels of soluble adhesion molecules in infants of <30 weeks’ gestation with respiratory distress syndrome (RDS) and to look for differences in these levels in neonates who subsequently developed bronchopulmonary dysplasia (BPD) compared with those neonates who did not, and also to investigate the effect of dexamethasone treatment on levels of soluble adhesion molecules in plasma.

Methods. We measured plasma concentrations of soluble L-selectin (sL-selectin), soluble E-selectin (sE-selectin), and soluble intercellular adhesion molecule-1 on days 1, 3, 7, 14, 21, and 28 of life and before and 2 to 3 days after initiating a 6-day course of dexamethasone treatment. Infants with RDS were followed until discharge and were classified as non-BPD and either 1) BPD day 28 reflecting oxygen requirement on day 28 but not at 36 corrected weeks or 2) BPD 36 weeks reflecting oxygen requirement at 36 (corrected) weeks’ gestation. The classification of presence or absence of BPD by oxygen requirement was supported by and was consistent with radiologic findings of BPD for all infants. The difference between BPD day 28 and BPD 36 weeks was supported by more extensive radiologic effects in the latter.

Results. The arterial plasma level of sL-selectin in infants who had RDS and did not develop BPD was significantly decreased compared with term healthy infants, as was the level of sE-selectin. Compared with infants who had RDS and did not develop BPD, sL-selectin levels were even further decreased in infants who had RDS and did develop BPD both at birth and throughout the first 4 weeks of life (day 1 through day 28). Infants with BPD also showed increasing levels of sE-selectin during this period of time, whereas infants without BPD did not. Levels of soluble intercellular adhesion molecule-1 in infants without BPD were not different from infants with BPD initially but increased in infants with BPD compared with infants without BPD, significant on day 28 in both groups. Dexamethasone treatment increased concentration of sL-selectin and decreased concentration of sE-selectin.

Conclusions. Low sL-selectin may be an early indicator of enhanced risk for BPD. Low levels of sL-selectin and increasing levels of sE-selectin may be risk factors for BPD. The effects of dexamethasone treatment include significant modulation of adhesion molecules.

Key Words: soluble E-selectin • soluble L-selectin • soluble ICAM-1 • dexamethasone • bronchopulmonary dysplasia

Abbreviations: BPD, bronchopulmonary dysplasia • RDS, respiratory distress syndrome • sE-selectin, soluble E-selectin • sL-selectin, soluble L-selectin • sICAM-1, soluble intercellular adhesion molecule-1 • CPAP, continuous positive airway pressure • RMANCOVA, repeated measures analysis of covariance • RMANOVA, repeated measures analysis of variance

Received for publication Feb 26, 2002; Accepted Aug 12, 2002.




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Soluble factors and the effect of steroids in BPD
KHALID KAMAL
Pediatrics Online, 5 Mar 2003 [Full text]
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Praveen Ballabh, et al.
Pediatrics Online, 25 Mar 2003 [Full text]