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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2008

01-10-2008 | Pediatric Original

Secretory phospholipase A2 and neonatal respiratory distress: pilot study on broncho-alveolar lavage

Authors: Daniele De Luca, Silvia Baroni, Giovanni Vento, Marco Piastra, Domenico Pietrini, Federica Romitelli, Ettore Capoluongo, Costantino Romagnoli, Giorgio Conti, Enrico Zecca

Published in: Intensive Care Medicine | Issue 10/2008

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Abstract

Purposes

Secretory phospholipase A2 hydrolyzes phosphoglycerides and it has been shown to be involved in alveolar inflammation and surfactant degradation. It plays an important role in acute lung injury but it has never been studied in newborn infants. We were aimed to investigate the phospholipase A2 activity in neonatal lung injury and its relationship with ventilatory findings.

Setting

Third level university hospital NICU.

Methods

We measured phospholipase activity in broncho-alveolar lavage fluid of 21 neonates with hyaline membrane disease, 10 with pneumonia or sepsis and 10 controls, ventilated for extrapulmonary reasons. Fluid was obtained before surfactant administration on the first day of life and phospholipase activity was measured using an ultrasensitive enzymatic method. Before lavage, lung mechanics in pressure controlled synchronized intermittent mandatory ventilation was analyzed.

Results

Phospholipase A2 was higher in babies ventilated for sepsis/pneumonia compared to hyaline membrane disease and to control babies. Phospholipase correlated negatively with dynamic compliance, positively with inspired oxygen fraction, mean airway pressure and oxygenation index. These correlations still remained significant after multivariate analysis, adjusting for possible confounding factors. Phospholipase was not correlated with blood and alveolar pH, gestational age, birth weight, blood gases, Apgar score, tidal volume, surfactant need and ventilation time.

Conclusions

These are the first data about phospholipase A2 in neonates. The enzyme plays a role in neonatal lung injury, especially in infection related respiratory failure. It is associated with lung stiffness, higher mean airway pressure and need for oxygen.
Literature
1.
Touqui L, Wu YZ (2003) Interaction of secreted phospholipase A2 and pulmonary surfactant and its pathophysiological relevance in acute respiratory distress syndrome. Acta Pharmacol Sin 24:1292–1296PubMed
2.
Dennis EA (1997) The growing phospholipase A2 superfamily of signal transduction enzymes. Trends Biochem Sci 22:1–2PubMedCrossRef
3.
Waite M (1996) Phospholipases. In: Vance DE, Vance JE (eds) Biochemistry of lipids, lipoproteins and membranes, 3rd edn edn. Elsevier , Amsterdam
4.
Touqui L, Arbibe L (1999) A role for phospholipase A2 in ARDS pathogenesis. Mol Med Tod 5:244–249CrossRef
5.
Nakos G, Kitsiouli E, Hatzidaki E, Koulouras V, Touqui L, Lekka ME (2005) Phospholipases A2 and platelet-activating-factor acetylhydrolase in patients with acute respiratory distress syndrome. Crit Care Med 33:772–779PubMedCrossRef
6.
Wheeler DS (2005) Phospholipases A2 and acute lung injury: it’s just not that simple. Crit Care Med 33:904–905PubMedCrossRef
7.
Avery G (2005) Avery’s diseases of the newborn. In: Taeusch HW, Ballard R, Gleason CA (eds) 8th edn. Elsevier/Saunders, Amsterdam/Philadelphia
8.
Khammash H, Perlman M, Wojtulewicz J, Dunn M (1993) Surfactant therapy in full-term neonates with severe respiratory failure. Pediatrics 92:135–139PubMed
9.
Herting E, Gefeller O, Land M, van Sonderen L, Harms K, Robertson B, Members of the Collaborative European Multicenter Study Group (2000) Surfactant treatment of neonates with respiratory failure and group B streptococcal infection. Pediatrics 106:957–964PubMedCrossRef
10.
De Luca D, Baroni S, Piastra M, Pietrini D, Romagnoli C, Zecca E (2007) Secretory phospholipase A2 and lung mechanics in neonatal acute lung injury: preliminary results. Acta Paediatr 96(suppl 456):83 (abstract)
11.
Walti H, Couchard M, Relier JP (1989) Neonatal diagnosis of respiratory distress syndrome. Eur Respir J 2(suppl 2):22s–27s
12.
American Heart Association, American Academy of Pediatrics (2006) 2005 Amercian Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care of pediatric and neonatal patients: neonatal resuscitation guidelines. Pediatrics 117:1029–1038CrossRef
13.
Zecca E, De Luca D, Baroni S, Vento G, Tiberi E, Romagnoli C (2008) Bile acid induced lung injury in newborn infants: a broncho-alveolar lavage fluid study. Pediatrics 121:e146–e149PubMedCrossRef
14.
Reynolds LJ, Hughes LL, Yu L, Dennis EA (1994) 1-Hexadecyl-2-arachidonoylthio-2-deoxy-sn-glycero-3-phosphorylcholine as a substrate for the microtiterplate assay of human cytosolic phospholipase A2. Anal Biochem 217:25–32PubMedCrossRef
15.
Capoluongo E, Ameglio F, Lulli P, Minucci A, Santonocito C, Concolino P, Di Stasio E, Boccacci S, Vendettuoli V, Giuratrabocchetta G, De Cunto A, Tana M, Romagnoli C, Zuppi C, Vento G (2007) Epithelial lining fluid free IGF-I-to-PAPP-A ratio is associated with bronchopulmonary dysplasia in preterm infants. Am J Physiol Endocrinol Metab 292:E308–E313PubMedCrossRef
16.
Rennard SI, Basset G, Lecossier D, O’Donnell KM, Pinkston P, Martin PG, Crystal RG (1986) Estimation of volume of epithelial lining fluid recovered by lavage using urea as marker of dilution. Appl Physiol 60:532–538
17.
Eberhard A, Carry PY, Perdrix JP, Fargnoli JM, Biot L, Baconnier PF (2003) A program based on a ‘selective’ least-squares method for respiratory mechanics monitoring in ventilated patients. Comput Methods Programs Biomed 71:39–61PubMedCrossRef
18.
Cappa P, Sciuto SA, Silvestri S (2006) Experimental evaluation of errors in the measurement of respiratory parameters of the newborn performed by a continuous flow neonatal ventilator. J Med Eng Technol 30:31–40PubMedCrossRef
19.
Norusis M (2004) SPSS 13.0 advanced statistical procedures companion. Prentice Hall Inc., Upper Saddle-River
20.
Attalah HL, Wu Y, Alaoui-El-Azher M, Thouron F, Koumanov K, Wolf C, Brochard L, Harf A, Delclaux C, Touqui L (2003) Induction of type IIA secretory phospholipase A2 in animal models of acute lung injury. Eur Respir J 21:1040–1045PubMedCrossRef
21.
Murakami M, Nakatani Y, Atsumi G, Inoue K, Kudo I (1997) Regulatory functions of phospholipase A2. Crit Rev Immunol 17:225–283PubMed
22.
Yoshikawa S, Miyahara T, Reynolds SD, Stripp BR, Anghelescu M, Eyal FG, Parker JC (2005) Clara cell secretory protein and phospholipase A2 activity modulate acute ventilator-induced lung injury in mice. J Appl Physiol 98:1264–1271PubMedCrossRef
23.
De Castro CM, Bureau MF, Nahori MA, Dumarey CH, Vargaftig BB, Bachelet M (1995) Modulation by dexamethasone of phospholipase A2 activities in endotoxemic guinea pigs. J Appl Physiol 79:1271–1277PubMed
24.
Andreani M, Olivier JL, Berenbaum F, Raymondjean M, Bereziat G (2000) Transcriptional regulation of inflammatory secreted phospholipases A2. Biochim Biophys Acta 1488:149–158PubMed
25.
Sweet D, Bevilacqua G, Carnielli V, Greisen G, Plavka R, Didrik Saugstad O, Simeoni U, Speer CP, Valls-I-Soler A, Halliday H, Working Group on Prematurity of the World Association of Perinatal Medicine, European Association of Perinatal Medicine (2007) European consensus guidelines on the management of neonatal respiratory distress syndrome. J Perinat Med 35:175–186
26.
Arbibe L, Koumanov K, Vial D, Rougeot C, Faure G, Havet N, Longacre S, Vargaftig BB, Bereziat G, Voelker DR, Wolf C, Touqui L (1998) Generation of lyso-phospholipids from surfactant in acute lung injury is mediated by type-II phospholipase A2 and inhibited by a direct surfactant protein A-phospholipase A2 protein interaction. J Clin Invest 102:1152–1160PubMedCrossRef
27.
Gregory TJ, Longmore WJ, Moxley MA, Whitsett JA, Reed CR, Fowler AAIII, Hudson LD, Maunder RJ, Crim C, Hyers TM (1991) Surfactant chemical composition and biophysical activity in acute respiratory distress syndrome. J Clin Invest 88:1976–1981PubMedCrossRef
28.
Sun B, Curstedt T, Lindgren G, Franzén B, Alaiya AA, Calkovská A, Robertson B (1997) Biophysical and physiological properties of a modified porcine surfactant enriched with surfactant protein A. Eur Respir J 10:1967–1974PubMedCrossRef
29.
Anzueto A, Baughman RP, Guntupalli KK, Weg JG, Wiedmann HP, Raventos AA, Lemaire F, Long W, Zaccardelli DS, Pattishall EN (1996) Aerosolized surfactant in adults with sepsis-induced acute respiratory distress syndrome. Exosurf Acute Respiratory Distress Syndrome Sepsis Study Group. N Engl J Med 344:1417–1421CrossRef
30.
Wang Z, Chang Y, Schwan AL, Notter RH (2007) Activity and inhibition resistance of a phospholipase-resistant synthetic surfactant in rat lungs. Am J Respir Cell Mol Biol 37:387–394PubMedCrossRef
31.
Duncan Hite R, Seeds MC, Safta AM, Jacinto RB, Gyves JA, Bass DA, Waite BM (2005) Lysophospholipid generation and phosphatidylglicerol depletion in phospholipase A2-mediated surfactant dysfunction. Am J Physiol Lung Cell Mol Physiol 288:L618–L624PubMedCrossRef
32.
Kim DK, Fukuda T, Thompson BT, Cockrill B, Hales C, Bonventre JV (1995) Bronchoalveolar lavage fluid phospholipase A2 activities are increased in human adult respiratory distress syndrome. Am J Physiol 269:109–118
33.
Abraham E, Naum C, Bandi V, Gervich D, Lowry SF, Wunderink R, Schein RM, Macias W, Skerjanec S, Dmitrienko A, Farid N, Forgue ST, Jiang F (2003) Efficacy and safety of LY315920Na/S-5920, a selective inhibitor of 14-kDa group IIA secretory phospholipase A2, in patients with suspected sepsis and organ failure. Crit Care Med 31:718–728PubMedCrossRef
Metadata
Title
Secretory phospholipase A2 and neonatal respiratory distress: pilot study on broncho-alveolar lavage
Authors
Daniele De Luca
Silvia Baroni
Giovanni Vento
Marco Piastra
Domenico Pietrini
Federica Romitelli
Ettore Capoluongo
Costantino Romagnoli
Giorgio Conti
Enrico Zecca
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 10/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1224-3

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