Inflammatory indices in meconium aspiration syndrome

Hofer, Nora; Jank, Katharina; Strenger, Volker; Pansy, Jasmin; Resch, Bernhard

doi:10.1002/ppul.23349

Cited by 25 publications

(19 citation statements)

References 39 publications

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“…Manuscript to be reviewed in inflammatory biomarkers was associated with relatively higher incidence of MAS. Consistent to our findings, Hofer et al reported that elevated CRP levels and changes in white blood cell/neutrophil counts were associated with the severity of MAS, although this study simultaneously highlighted the potential impact of mechanical ventilation on the inflammatory biomarkers (Hofer et al, 2016). Further accumulation of knowledge regarding the role of inflammatory reactions may accelerate the establishment of biomarkers, which provide early, precise prediction of MAS development in neonates, who are born through meconium-stained amniotic fluid.…”

Section: Discussionsupporting

confidence: 89%

Peer Review #2 of "Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid (v0.1)"

Ramaswamy¹

2019

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Background: Meconium-stained amniotic fluid is observed in approximately 10-15% of all deliveries, however, only 5% of neonates with meconium-stained amniotic fluid develop meconium aspiration syndrome (MAS). Although foetal distress and subsequent sympathetic stimulation have been considered as the primary upstream events of MAS, this clinical complication sometimes occurs due to other pathologies, such as intraamniotic inflammation. The aim of this study was to investigate whether the incidence of MAS is associated with the presence of funisitis and chorioamnionitis in term neonates with meconium-stained amniotic fluid. Methods: Between April 2013 and March 2015, 95 term neonates with meconium-stained amniotic fluid, who were hospitalized at a neonatal intensive care unit, were enrolled in the study. The placenta and umbilical cord were histopathologically examined. Clinical variables and histopathological findings associated with the incidence of MAS were studied. Results: A total of 36 neonates developed MAS. Univariate logistic regression analysis revealed that a heavier birth weight, male sex, 1-min Apgar score ≤ 7, funisitis (but not chorioamnionitis), and elevated acute-phase inflammatory reaction score were associated with increased incidence of MAS (all p < 0.05). The multivariate model comprised funisitis (OR=5.03, 95%CI, 1.63-15.5), 1-min Apgar score ≤ 7 (OR=2.74,95%CI, 1.06-7.09), and male sex (OR=3.4, 95%CI, 1.24-9.34). Conclusion: In neonates with meconium-stained amniotic fluid, funisitis, as well as low 1-min Apgar score and male sex, was identified as an independent variable for MAS development. Intraamniotic inflammation might be involved in the pathological mechanisms of MAS.

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Section: Discussionsupporting

confidence: 89%

Peer Review #2 of "Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid (v0.1)"

Ramaswamy¹

2019

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“…Recently investigators have found that there is a relationship between MAS and a combination of intra‐amniotic inflammation and fetal systemic inflammation . In a 25 years retrospective survey, a close link between the severity of MAS and several inflammatory criteria among patients without a co‐existent bacteria infection has been identified . These studies have re‐emphasized the role of inflammation in MAS pathophysiology and the importance of anti‐inflammatory therapy when carrying out MAS management.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different dosing strategies of intratracheally instilled budesonide on meconium injured piglet lungs

Lin¹,

Jeng

Yang

et al. 2017

Pediatric Pulmonology

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“…Experimental studies have revealed that meconium induces a potent local inflammation in the lungs, with the features: leukocyte infiltration, alveolar macrophage activation, the release of myeloperoxidase (MPO), increased cytokine formation, and apoptosis [5]. Additionally, MAS-induced complement activation and cytokine release has been shown experimentally in piglets [6], and the systemic inflammatory response has been shown to correlate with the severity of MAS among neonates [7]. …”

Section: Introductionmentioning

confidence: 99%

Combined Inhibition of C5 and CD14 Attenuates Systemic Inflammation in a Piglet Model of Meconium Aspiration Syndrome

et al. 2018

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Background: Meconium aspiration syndrome (MAS) is a severe lung condition affecting newborns and it can lead to a systemic inflammatory response. We previously documented complement activation and cytokine release in a piglet MAS model. Additionally, we showed ex vivo that meconium-induced inflammation was dependent on complement and Toll-like receptors. Objectives: To assess the efficacy of the combined inhibition of complement (C5) and CD14 on systemic inflammation induced in a forceful piglet MAS model. Methods: Thirty piglets were randomly allocated to a treatment group receiving the C5-inhibitor SOBI002 and anti-CD14 (n = 15) and a nontreated control group (n = 15). MAS was induced by intratracheal meconium instillation, and the piglets were observed for 5 h. Complement, cytokines, and myeloperoxidase (MPO) were measured by ELISA. Results: SOBI002 ablated C5 activity and the formation of the terminal complement complex in vivo. The combined inhibition attenuated the inflammasome cytokines IL-1β and IL-6 by 60 (p = 0.029) and 44% (p = 0.01), respectively, and also MPO activity in the bronchoalveolar fluid by 42% (p = 0.017). Ex vivo experiments in human blood revealed that the combined regimen attenuated meconium-induced MPO release by 64% (p = 0.008), but there was only a negligible effect with single inhibition, indicating a synergic cross-talk between the key molecules C5 and CD14. Conclusion: Combined inhibition of C5 and CD14 attenuates meconium-induced inflammation in vivo and this could become a future therapeutic regimen for MAS.

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Inflammatory indices in meconium aspiration syndrome

Abstract: High CRP and IT-ratio and low WBC and ANC values were closely linked to a more severe course of MAS during the early phases of the disease. These findings reflect the role of inflammation in the pathogenesis of MAS. Pediatr Pulmonol. 2016;51:601-606. 2015 Wiley Periodicals, Inc.

Cited by 25 publications

References 39 publications

Peer Review #2 of "Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid (v0.1)"

Peer Review #2 of "Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid (v0.1)"

Comparison of different dosing strategies of intratracheally instilled budesonide on meconium injured piglet lungs

Combined Inhibition of C5 and CD14 Attenuates Systemic Inflammation in a Piglet Model of Meconium Aspiration Syndrome

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