ABSTRACT:Oxygen is essential therapy for neonates with acute respiratory failure, including those with infections. However, high oxygen levels may be counterproductive for overcoming infections because hyperoxia may kill cells, including dendritic cells that are essential to the emergence of the pulmonary immune system and pivotal in mounting immune responses to infections. We studied the impact of hyperoxia on developing dendritic cells from neonatal cord blood and adult blood monocytes, comparing viability, development of maturation, and endocytic function. Our data suggest that cord blood-derived dendritic cells may be more resistant to hyperoxicinduced cell death than adult blood-derived cells. Moreover, the surviving cells in either group are those that maintain an immature phenotype. This may impair their ability to perform optimal immune function. I nfection is one of the most important causes of mortality and morbidity among newborns with acute respiratory failure (1). Inhaled oxygen is a vital therapy for these infants, despite the potential risks of hyperoxia to the lung, including affecting the DNA integrity of type II pneumocytes (2), and normal immune responses in the lungs (3,4). Hyperoxia alters the pulmonary tissue immune response by up-regulating proinflammatory cytokines and inducing neutrophil infiltration in the alveolar spaces (5). It also increases alveolar macrophage apoptosis (4), further weakening the immune response (3). We investigated whether hyperoxia might likewise interfere with the development of DC, immune cells that are more important for presenting antigen to T cells than are macrophages.While the majority of term infants exposed to hyperoxia recover, occasionally with some residual morbidity, adults under similar conditions do not survive beyond a few days (6,7). To investigate whether this differential response to oxygen is reflected in DC function and viability, we compared the hyperoxic effect on developing DC from neonates versus adults.
MATERIALS AND METHODSCell culture and hyperoxia. Pulmonary dendritic cells, which are exposed to the highest levels of oxygen, are predominantly of myeloid origin (8) and resemble monocyte-derived DC from cord or adult peripheral blood (9). After institutional board review and informed consent, cord blood from normal term pregnancies was collected into sterile collection bags and processed within 24 h. Some cord blood was supplied by the St. Louis Cord Blood Bank and solely used for determining the optimal duration of hyperoxia exposure. Although the blood from preterm cord blood would be more reflective of the clinical setting underlying this study, limited volume and, therefore, smaller cell numbers made it impractical. Adult blood was collected by venipuncture from healthy volunteers. The dendritic progenitor cells were extracted from mononuclear cells as described previously (10). Briefly, the mononuclear cells were separated from red cells by sedimentation with a solution of hydroxyethyl starch followed by density centrifugation over ...