Ascorbate acid concentration in airways lining fluid from infants who develop chronic lung disease of prematurity

Chronic lung disease of prematurity (CLD) remains a common cause of morbidi ty and mortality in preterm infants. Oxygen toxicity remains a major risk f actor for the development of CLD and as a consequence the antioxidant statu s of CLD babies is a major focus of interest. In the present study, we dete rmined whether ascorbate, urate, and total glutathione concentrations were decreased in infants who developed CLD when compared to those who did not. From 34 preterm infants, 141 serial bronchoalveolar lavage fluid (BALF) and plasma samples were collected: 12 developed CLD (median gestation 26 weeks , range 23-28 weeks, median birth weight 780 g, range 630-1070 g), 16 devel oped and recovered from respiratory distress syndrome (RDS) (median gestati on 31 weeks, range 26-39 weeks, median birth weight 1820 g, range 840-4160 g), and six were ventilated for non-respiratory reasons, (median gestation 35 weeks, range 32-38 weeks, median birth weight 2180 g, range 1100-2860 g) . Following birth, the concentration of BALF ascorbate, urate and glutathio ne decreased over the Ist week in all three groups. Thereafter, BALF ascorb ate increased in RDS and control infants during the 2nd week but this incre ase was delayed by 2 weeks in the CLD infants. No differences were noted be tween the RDS and CLD groups for urate and total glutathione in BALF or ura te ill plasma. BALF protein concentration was similar in all three groups e xcept for a rise at day 7 in the CLD group but this did not reach statistic al significance. Conclusion A delayed increase in bronchoalveolar lavage fluid ascorbate con centration might be associated with an increased risk of developing chronic lung disease of prematurity.