Further observations on serum proteins in respiratory distress syndrome of the newborn.

Abstract

In our initial study of newborn infants suffering from the respiratory distress syndrome (RDS) (Hardie, Heese, and Kench, 1965), it was found that affected infants had significantly lower serum concentrations of total proteins than normal premature infants, and that the relative and absolute concentrations of y-globulins, as determined by paper electrophoresis, were much diminished. These abnormalities were present in the cord blood and became more marked in the first 2 to 3 days.In that paper we suggested that the y-globulin deficiency could be due to either (1) defective placental transfer of y-globulins, or (2) excessive y-globulin katabolism by the affected fetus and newborn, or (3) an immune reaction taking place in the fetus and newborn involving the maternal y-globulins as either antibodies or antigens.With these possibilities in mind a more detailed and extensive investigation of the serum proteins in this condition is described.Clinical Material and Methods Subjects of the study were either normal premature infants or premature babies suffering from RDS. The mean gestational age of the normal premature infants for whom data were available (72 of the 88 in the series) was 33 9 weeks. All the RDS infants (33) were traced, and these had a mean gestational age of 35-2 weeks. The clinical criteria for diagnosis of RDS were as before (Hardie et al., 1965). They were the presence of at least two of the following features for which no other obvious cause could be found: (1) cyanosis; (2) rib recession; (3) expiratory grunting; (4) generalized oedema; and (5) a 'ground glass' opacity on x-ray of the lung fields with an air bronchogram.Where the patient presented with cyanosis and

Glucocorticoid levels in maternal and cord serum after prenatal betamethasone therapy to prevent respiratory distress syndrome.

“…Transcortin capacity in these and other samples was calculated from the amount of binding at a cortisol level of 50 ,Ag per 100 ml (21). The amount of unbound cortisol and cortisol bound to albumin was estimated (22) from these data by using published values for cord blood albumin levels in premature infants with and without RDS (23).…”

Low antithrombin III in neonatal shock: DIC or non-specific protein depletion?

“…One such trial, involving the administration of AT III concentrates to newborn infants with respiratory distress syndrome and "DIC" is currently underway [16]. On the other hand, it is well known that serum albumin is decreased in the neonatal respiratory distress syndrome [9]. We find it therefore difficult to conclude that low levels of AT III or any other coagulation protein in an infant with respiratory distress syndrome implies DIC and not just non-specific protein depletion.…”

“…Further, the non-coagulation protein albumin is decreased significantly in clinical conditions known to predispose to DIC such as septicaemic shock [4], and the neonatal respiratory distress syndrome [9]. With its molecular weight of 58000 ATIII closely resembles albumin in molecular size.…”