Dexamethasone Alters Tracheal Aspirate T-Cell Cytokine Production in Ventilated Preterm Infants.
Siamak M YazdiEkta U PatelColby D RichardsonK Thomas HardyJohn E BaatzJennifer K MulliganRita M RyanPublished in: Children (Basel, Switzerland) (2021)
Postnatal corticosteroids improve respiratory status and facilitate respiratory support weaning in preterm infants with bronchopulmonary dysplasia (BPD). Older literature describes characteristic cytokine profiles in tracheal aspirates (TA) of BPD patients which are altered with corticosteroids. Corticosteroids also influence peripheral blood T-cell presence. However, little is known regarding TA T-cell phenotype and cytokine production before or after exogenous corticosteroids. We hypothesized that postnatal dexamethasone alters the TA T-cell cytokine profiles of preterm infants. TA samples were collected from 14 infants born from 23 0/7 to 28 6/7 weeks who were mechanically ventilated for at least 14 days. Samples were collected up to 72 h before a ten-day dexamethasone course and again 1 to 3 calendar days after dexamethasone initiation. The primary outcome was change in T cell populations present in TA and their intracellular cytokine profile after dexamethasone treatment, ascertained via flow cytometry. Following dexamethasone treatment, there were significant decreases in respiratory severity score (RSS), percent CD4+IL-6+ cells, CD8+IL-6+ cells, CXCR3+IL-6+ cells, and CXCR3+IL-2+ cells and total intracellular IFN-γ in TA. RSS significantly correlated with TA percent CD4+IL-6+ cells. To our knowledge, this is the first study demonstrating that dexamethasone reduced T-cell IL-6 and this reduction was associated with improved RSS in pre-term infants with evolving BPD.
Keyphrases
- preterm infants
- induced apoptosis
- cell cycle arrest
- low dose
- high dose
- low birth weight
- peripheral blood
- systematic review
- flow cytometry
- end stage renal disease
- intensive care unit
- immune response
- physical activity
- gestational age
- chronic kidney disease
- cell proliferation
- oxidative stress
- acute respiratory distress syndrome
- signaling pathway
- peritoneal dialysis
- middle aged
- nk cells
- combination therapy
- preterm birth
- extracorporeal membrane oxygenation