1823 Ceruloplasmin (Cer) Levels in Prematures at Risk for Bronchopulmonary Dysplasia (Bpd)

Abstract

Twenty two c h i l d r e n (age range :3-14 years, Sex:m:f: :12:lO) adm i t t e d t o Kings County H o s p i t a l o f Brooklyn w i t h s t a t u s asthmaticus were s t u d i e d t o determine t h e i r plasma ADH l e v e l s i n r e l a t i o n t o the s e v e r i t y o f the s t a t u s asthmaticus. Plasma ADH l e v e l s were measured b y RIA a t t h e time o f admission and again a t 1-2 weeks f o l l o w i n g recovery from s t a t u s . The r e s u l t s are shown i n t h e table.We conclude from t h e study t h a t 1. AOH r esponse increases w i t h s e v e r i t y o f s t a t u s asthmaticus 2. With h i g h sp. g r . o f u r i n e d u r i n g s t a t u s , i n add i t i o n t o dehydration increased ADH s e c r e t i o n should be k e p t i n mind and 3. I n a d d i t i o n t o o t h e r known f a c t o r s , increased ADH may p l a y a r o l e i n pulmonary edema w i t h s t a t u s asthmaticus.GROUP I GROUP I I n=14 n =8 W e s t u d i e d t h e v e n t i l a t o r y response t o hypoxia i n 7 newborn k i t t e n s (n=12), 2 t o 28 days o l d , K i t t e n s were s u r g i c a l l y instrumented t o record diaphragmatic EMG (EMGD~), eye movements (EOG), e l e c t r o c o r t i c a l a c t i v i t y (ECoG), and neck EMG, Ventilat i o n (OE) was measured with a mask and a flow-through system. K i t t e n s i n h a l e d 21% 02 f o r a c o n t r o l period of a t l e a s t 2 min, 10% 02 f o r 10 min, and 21% 02 f o r 2 min again. Measurements were made i n q u i e t s l e e p . With a decrease i n Fi02 t o lo%, t h e r e was an immediate i n c r e a s e i n OE (0,210+0.017 t o 0.30020,025 L/min/kg; p<0,005) which was n o t s u s t a i n e d , v e n t i l a t i o n decreasing t o 0,224 20,028 by 10 min of hypoxia. VT i n c r e a s e d from 3,820.2 mllkg t o 5.0'0,4 (p<0.005) and then decreased t o 3,9'0.2. Frequency in-c r e r s e d from 56'4.0 breathslmin t o 6323 (p<0.02) and then decreased t o 5525, The changes i n I E M G D~X~ followed those i n vE0 K i t t e n s s t u d i e d b e f o r e 7 days of l i f e had a more pronounced dec r e a s e i n v e n t i l a t o r y output a t 10 min of hypoxia than o l d e r k i tt e n s , Breathing p a t t e r n became i r r e g u l a r o r p e r i o d i c during hypoxia.On r e t u r n t o 21% 02 v e n t i l a t o r y output decreased a b r u p t l y due t o apnea. These r e s u l t s suggest; 1) t h e hyperventil a t o r y response t o hypoxia i n unanesthetized k i t t e n s i s not w e l l s u s t a i n e d with values a t end of hypoxia c l o s e t o c o n t r o l l e v e l s ;2) t h e b i p h a s i c response t o hypoxia i s p r i m a r i l y a f u n c t i o n of frequency; 3) younger k i t t e n s a r e l e s s a b l e t o s u s t a i n hypervent i l a t i o n than o l d e r k i t t e n s , W e s p e c u l a t e t h a t t h e l a t e f a l l i n v e n t i l a t i o n i s due t o a c e n t r a l mechanism a f f e c t i n g frequency. Arousal from q u i e t sleep (QS) i n response t o a hypoxic challenge (HC) does n o t occur i n many apnea o f infancy (AOI) p ...

Gestational Age-Dependent Reference Values for Iron and Selected Proteins of Iron Metabolism in Serum of Premature Human Neonates

“…These exclusion criteria were chosen because previous investigations could demonstrate significantly lower serum transferrin and/or ceruloplasmin concentrations in prematures suffering PIVH or BPD [4,5]. Finally, 63 premature newborns remained in the study group.…”

“…The role of free ionic iron (Fe 2+ ) in the generation of oxygen free radicals as well as the antioxidative properties of ceruloplasmin (oxidation of Fe 2+ → Fe 3+ ) and transferrin (ligation of Fe 3+ ) thereafter have been the subject of many investigations. These studies suggest that either increased serum iron concentrations and/or decreased serum transferrin and ceruloplasmin levels may be associated with the development of radical-induced diseases of prematurity, e.g., retinopathy of prematurity (ROP), periventricular-intraventricular hemorrhage (PIVH), bronchopulmonary dysplasia (BPD) or necrotizing enterocolitis (NEC) [3][4][5]. To identify a premature newborn possibly at risk for the development of such a disorder, gestational age-dependent reference ranges of these laboratory values are needed.…”

“…To identify a premature newborn possibly at risk for the development of such a disorder, gestational age-dependent reference ranges of these laboratory values are needed. Unfortunately, previous studies either did not take into account the expected changes with gestational age [1,6], or they confined their investigations to only one or two of these iron metabolismassociated laboratory values, so that any comparative statement seems questionable [1,[5][6][7][8][9][10]. Therefore, it was the aim of the present study to establish reference values for serum iron, transferrin, ferritin and ceruloplasmin concentrations in premature human neonates, thereby paying attention to the possible changes with gestational age.…”

Functional and Antigenic Concentrations of Alpha-1-Proteinase Inhibitor after Administration for the Prevention of Chronic Lung Disease of Prematurity

“…Several studies have shown reduced A1PI functional activity [3][4][5][6][7] or higher tracheal elastase activity [5][6][7][8][9] in preterm babies who later developed CLD compared to those who did not. Based on these and other observations, it was hypothesized that treatment of premature babies with A1PI would result in augmentation of antiprotease activity, inhibition of neutrophil elastase activity and protection from the development of CLD.…”

Perinatal prevention of bronchopulmonary dysplasia

“…Infants who develop BPD have a 20-fold increase in the neutrophil infl ux [54] and an imbalance between proteases and antiproteases [83] . A low functional level of α 1-protease inhibitor at birth may predict BPD development [68] , but in an RCT of neonates aged < 24 h, with birth weights between 600 and 1000 g, and requiring respiratory support or with birth weight between 1001 and 1250 g and with RDS, supplementation did not result in a signifi cant reduction in BPD, but there was a lower incidence of pulmonary haemorrhage [83] .…”