Airway Angiopoietin-2 in Ventilated Very Preterm Infants: Association With Prenatal Factors and Neonatal Outcome

作者:Thomas Wolfgang*; Seidenspinner Silvia; Kramer Boris W; Wirbelauer Johannes; Kawczynska Leda Natalia; Szymankiewicz Marta; Speer Christian P
来源:Pediatric Pulmonology, 2011, 46(8): 777-784.
DOI:10.1002/ppul.21435

摘要

Objective: Pulmonary angiogenesis is a prerequisite for lung development. Angiopoietin-2 (Ang2) destabilizes endothelial cells through its endothelial receptor TIE-2, enabling vascular sprouting. Ang1 stabilizes new blood vessels. Soluble TIE-2 (sTIE-2) modulates these effects. We hypothesized that histological funisitis is associated with alterations of Ang2 in airways and of the systemic angiopoietin-TIE-2 homeostasis in very low birth weight (VLBW) infants, contributing to pulmonary morbidity and mortality. Methods: We measured Ang2 in tracheobronchial aspirate fluid (TAF) of 42 VLBW <30 weeks of gestation from day 1 through 15 and Ang1, Ang2, and sTIE-2 in umbilical cord serum of 28 infants by enzyme-linked immunosorbent assay. Histological examination distinguished three groups: funisitis, chorioamnionitis, and controls. Results: Funisitis was associated with lower Ang2 values in TAF but not with changes of Ang1, Ang2, and sTIE-2 in umbilical cord serum. Infants who developed bronchopulmonary dysplasia (BPD) or died had a persistently decreased ratio of previously measured Ang1 to Ang2 in TAF on days 1-5 and increased cord serum concentrations of sTIE-2. Moderate BPD/death was associated with an increase of Ang2 in TAF on day 10 and decreased Ang1/Ang2 ratio from day 3-15. Small for gestational age (SGA) infants had increased Ang2 in TAF on day 1-7 and a lower Ang1/Ang2 ratio on days 5-7. Conclusions: The predominance of Ang2 in airway fluid of infants with BPD/death and SGA infants suggests a link between disrupted placental and fetal pulmonary angiogenesis. Histological funisitis with reduced Ang2 in TAF was of minor relevance for outcome in our cohort. Pediatr Pulmonol. 2011; 46:777-784.

  • 出版日期2011-8