Complement and contact activation related to surfactant response in respiratory distress syndrome

Citation
Mh. Wagner et al., Complement and contact activation related to surfactant response in respiratory distress syndrome, PEDIAT RES, 45(1), 1999, pp. 14-18
Citations number
26
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
PEDIATRIC RESEARCH
ISSN journal
00313998 → ACNP
Volume
45
Issue
1
Year of publication
1999
Pages
14 - 18
Database
ISI
SICI code
0031-3998(199901)45:1<14:CACART>2.0.ZU;2-A
Abstract
The activation of inflammation and coagulation cascades is part of the path ogenesis of adult respiratory distress syndrome (RDS). Previous studies hav e demonstrated contact activation in preterm infants with RDS, whereas no c oncordant results have been found with complement activation. In this study , both systems were investigated in preterm infants with severe RDS and rel ated to surfactant response. Thirty preterm newborns with severe respirator y distress (Fio(2) > 0.5), but with no evidence of infection or fetal acido sis, were studied. Eighteen healthy preterm newborns of similar gestational age and birth weight served as controls. The study; group was divided into two subgroups, according to their response to a porcine natural surfactant 6 h after administration: responders (Fio(2) reduction > 50%) and poor res ponders (Fio(2) reduction less than or equal to 50%). Clq, C4, factor B, C3 a, C5a, complement, and CI-inhibitor activity, as well as factor XIIa, were determined in blood samples, drawn 24 h after birth. Except for C1-inhibit or concentration and C1-inhibitor activity, all parameters for infants with severe RDS were different from controls. Complement precursor proteins wer e lower, and activated split products of the complement and contact system were higher. Infants with a poor response after application of surfactant s howed higher amounts of C3a, C5a, and factor XIIa but lower Clq and C4 leve ls compared with infants with a good response to surfactant. Activation of the complement and the contact system was demonstrated in all respiratory d istress patients. This activation was more pronounced in poor responders to exogenous surfactant.