Role of distinct phospholipases A2 and their modulators in meconium aspiration syndrome in human neonates.
Summary of "Role of distinct phospholipases A2 and their modulators in meconium aspiration syndrome in human neonates."
PURPOSE:
Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harming the alveoli. Locally produced phospholipases might perpetuate the injury and influence clinical pictures and therapeutic approaches. Our aim is to verify whether pulmonary phospholipase A2 (sPLA2-IIA) is involved in the damage and to determine if phospholipases and their modulators are associated with MAS clinical pictures.
METHODS:
We studied distinct phospholipases A2 and their modulators in broncho-alveolar lavage (BAL) fluids and in meconium of five MAS neonates and in five control neonates ventilated for extrapulmonary reasons.
RESULTS:
MAS patients have higher amounts of pulmonary phospholipase (sPLA2-IIA; P = 0.016) and Clara cell secretory protein (CCSP; P = 0.032). The local production of such proteins by the lung is confirmed by their very low levels in meconium. sPLA2-IIA contributes to the higher total enzyme activity in MAS patients, as compared to controls (P = 0.008). Cytosolic phospholipase was not detected in meconium or alveolar fluid. sPLA2 activity and sPLA2-IIA concentrations are correlated with the TNFα and with the release of CCSP. sPLA2 total activity, sPLA2-IIA and TNFα concentrations in BAL fluids correlate with the oxygenation impairment and haemorrhagic lung oedema.
CONCLUSIONS:
Pulmonary sPLA2 is locally produced and contributes to the total sPLA2 activity during MAS. CCSP is also produced in trying to lower the inflammation. Both sPLA2 activity and sPLA2-IIA are significantly correlated with oxygenation impairment and haemorrhagic lung oedema.
Affiliation
Laboratory of Clinical Molecular Biology, Institute of Biochemistry, Servizio Analisi 1, University Hospital "A. Gemelli", Catholic University of the Sacred Heart, L.go A. Gemelli 8, 00168, Rome, Italy, dm.deluca@fastwebnet.it.
Journal Details
This article was published in the following journal.
Name: Intensive care medicine
ISSN: 1432-1238
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21567110
- DOI: http://dx.doi.org/10.1007/s00134-011-2243-z
Medical and Biotech [MESH] Definitions
Meconium Aspiration Syndrome
A condition caused by inhalation of MECONIUM into the LUNG of FETUS or NEWBORN, usually due to vigorous respiratory movements during difficult PARTURITION or respiratory system abnormalities. Meconium aspirate may block small airways leading to difficulties in PULMONARY GAS EXCHANGE and ASPIRATION PNEUMONIA.
Group V Phospholipases A2
A subcategory of secreted phospholipases A2 that contains both a negatively charged carboxy-terminal segment and interfacial-binding region specific for PHOSPHATIDYL CHOLINE-containing membranes. This enzyme group may play a role in the release of ARACHIDONIC ACID from phospholipid membranes.
Pneumonia, Aspiration
A type of lung inflammation resulting from the aspiration of food, liquid, or gastric contents into the upper RESPIRATORY TRACT.
Respiratory Aspiration
Breathing in liquid or solids, such as stomach contents, into the RESPIRATORY TRACT. When this causes severe lung damage, it is called ASPIRATION PNEUMONIA.
Phospholipases A
Phospholipases that hydrolyze one of the acyl groups of phosphoglycerides or glycerophosphatidates.
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