Prediction of Respiratory Distress Syndrome by the Level of Pulmonary Surfactant Protein A in Cord Blood Sera

Cho, Kazutoshi; Matsuda, Tadashi; Okajima, Satoru; Matsumoto, Yoshinori; Sagawa, Tadashi; Fujimoto, Seiichiro; Kobayashi, Kunihiko

doi:10.1159/000014198

Cited by 12 publications

(6 citation statements)

References 18 publications

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“…SP-D in bronchoalveolar lavage increases during the first days of life in prematurely born infants, and low concentration of SP-D was found to predict worse clinical outcome (14). The levels of SP-A in cord blood has been found to predict RDS among prematurely born infants (15). We have demonstrated that levels of SP-D in cord blood and capillary blood of mature newborn infants depend on several maternal and perinatal conditions (16) including labor, mode of delivery and maternal smoking.…”

Section: R Espiratory Distress Syndrome (Rds) Is a Main Contributormentioning

confidence: 99%

“…SP-D in bronchoalveolar lavage increases during the first days of life in prematurely born infants, and low concentration of SP-D was found to predict worse clinical outcome (14). The levels of SP-A in cord blood has been found to predict RDS among prematurely born infants (15 Abbreviations: CPAP, nasal continuous positive airway pressure; IUGR, intrauterine growth retardation; RDS, respiratory distress syndrome; ROM, rupture of membrane for more than 1 hour before birth; SP, surfactant protein …”

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confidence: 99%

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Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants. The Influence of Perinatal Factors

et al. 2006

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Surfactant protein D (SP-D) is a collectin that plays an important role in the innate immune system and takes part in the surfactant homeostasis by regulating the surfactant pool size. The aims of this study were to investigate the values of SP-D in umbilical cord blood and capillary blood of premature infants and to relate the levels to perinatal conditions. A total of 254 premature infants were enrolled in the present study. Umbilical cord blood was drawn at the time of birth and capillary blood at regular intervals throughout the admission. The concentration of SP-D in umbilical cord blood and capillary blood was measured using ELISA technique. The median concentration of SP-D in umbilical cord blood was twice as high as in mature infants, 769 ng/mL (range 140 -2,551), with lowest values in infants with intrauterine growth retardation (IUGR) and rupture of membranes (ROM). The median concentration of SP-D in capillary blood day 1 was 1,466 ng/mL (range 410 -5,051 ng/mL), with lowest values in infants born with ROM and delivered vaginally. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be more likely in infants in need for respiratory support or surfactant treatment and susceptibility to infections. We conclude that SP-D concentrations in umbilical cord blood and capillary blood in premature infants are twice as high as in mature infants and depend on several perinatal conditions. High SP-D levels in umbilical cord blood and capillary blood on day 1 were found to be related to increased risk of RDS and infections. R espiratory distress syndrome (RDS) is a main contributor to increased mortality and morbidity among premature infants. RDS is caused by lack of pulmonary surfactant leading to atelectasis and ventilation-perfusion mismatch of the lungs (1). Biochemically, pulmonary surfactant is a mixture of phospholipids and associated proteins which are synthesized, stored, secreted and recycled by type II cells in the airways (2). This mixture forms a monolayer at the air-liquid interface which lowers the surface tension, stabilizes alveoli and terminal airways at low lung volume and prevents alveolar collapse at the end of the expiration. Treatment with synthetic or naturally developed surfactant has been associated with a decline in the mortality of RDS among premature infants (3,4).Four specific surfactant proteins have been identified, called surfactant protein (SP) A-D. SP-B and SP-C have been characterized as hydrophobic polypeptides that enhance the adsorption of lipid to the surface of the alveoli (5), while SP-A and SP-D are hydrophilic and participate in the innate host defense immune system. SP-D binds to macrophages and neutrophils and promotes phagocytosis and killing of bacteria, fungi, and viruses (6). Polymorphism in the amino acid residue 11 of the SPD gene has been found to increase severity of respiratory syncytial virus infection and susceptibility to tuberculosis (7,8).SP-A and SP-B are instrumental in surfactant storage in lamellar bodies and i...

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Section: R Espiratory Distress Syndrome (Rds) Is a Main Contributormentioning

confidence: 99%

“…SP-D in bronchoalveolar lavage increases during the first days of life in prematurely born infants, and low concentration of SP-D was found to predict worse clinical outcome (14). The levels of SP-A in cord blood has been found to predict RDS among prematurely born infants (15 Abbreviations: CPAP, nasal continuous positive airway pressure; IUGR, intrauterine growth retardation; RDS, respiratory distress syndrome; ROM, rupture of membrane for more than 1 hour before birth; SP, surfactant protein …”

mentioning

confidence: 99%

Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants. The Influence of Perinatal Factors

et al. 2006

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“…Moreover, the expression of SP-A was very low56). The levels of SP-A in tracheal aspirates, cord blood, and serum of newborn infants with RDS were lower than in infants without RDS57,58,59,60). Owing to these significant findings and the important roles of SP-A in the pulmonary host defense mechanism and the formation of TM61,62,63), the genes expressing SP-A have been thought to be strong candidates for susceptibility to RDS.…”

Section: Candidate Genetic Polymorphisms Of Spsmentioning

confidence: 99%

Genetic risk factors associated with respiratory distress syndrome

2014

Korean J Pediatr

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Respiratory distress syndrome (RDS) among preterm infants is typically due to a quantitative deficiency of pulmonary surfactant. Aside from the degree of prematurity, diverse environmental and genetic factors can affect the development of RDS. The variance of the risk of RDS in various races/ethnicities or monozygotic/dizygotic twins has suggested genetic influences on this disorder. So far, several specific mutations in genes encoding surfactant-associated molecules have confirmed this. Specific genetic variants contributing to the regulation of pulmonary development, its structure and function, or the inflammatory response could be candidate risk factors for the development of RDS. This review summarizes the background that suggests the genetic predisposition of RDS, the identified mutations, and candidate genetic polymorphisms of pulmonary surfactant proteins associated with RDS.

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“…Currently, there are only a few reports describing the measurement of SP-A levels in cord blood and sera from neonates within 24 hours after birth [22,23]. To date, there are no data regarding C-proSP-B concentrations in the blood of newborn infants.…”

Section: Introductionmentioning

confidence: 99%

Fetal and neonatal samples of a precursor surfactant protein B inversely related to gestational age

et al. 2013

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BackgroundAlveolar–capillary membrane leaks can increase the amount of surfactant protein B (SP-B) in the bloodstream. The purpose of this study was to measure the concentration of C-proSP-B, a SP-B precursor that includes C-terminal domains, in various body fluids of newborn infants and determine its dependence on gestational age.MethodsC-pro-SPB was measured in amniotic fluid and umbilical cord blood at birth, and in peripheral blood and urine on postnatal day 3 in 137 newborn infants with a median birth weight of 2015 g (range, 550–4475 g) and gestational age of 34 weeks (range, 23–42 weeks).ResultsC-proSP-B levels differed more than 100-fold among samples. The levels (median; interquartile range) were highest in peripheral blood (655.6 ng/mL; 419.0-1467.0 ng/mL) and lowest in urine (3.08 ng/mL; 2.96-3.35 ng/mL). C-proSP-B levels in amniotic fluid (314.9 ng/mL; 192.7–603.6 ng/mL) were approximately half of those in peripheral blood. In cord blood C-proSP-B was slightly lower (589.1 ng/mL; 181.2-1129.0 ng/mL) compared with peripheral blood. C-proSP-B levels significantly increased in all the fluids sampled except urine with decreasing gestational age (p < 0.001).ConclusionsThis novel assay allows for the quantitative measurement of C-proSP-B in blood and amniotic fluid. The dependence of C-proSP-B on gestational age may hamper its use for the detection of alveolar leaks in preterm newborns.

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Prediction of Respiratory Distress Syndrome by the Level of Pulmonary Surfactant Protein A in Cord Blood Sera

Cited by 12 publications

References 18 publications

Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants. The Influence of Perinatal Factors

Surfactant Protein D Levels in Umbilical Cord Blood and Capillary Blood of Premature Infants. The Influence of Perinatal Factors

Genetic risk factors associated with respiratory distress syndrome

Fetal and neonatal samples of a precursor surfactant protein B inversely related to gestational age

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