Abstract：OBJECTIVE: Recent studies have suggested that acute lung injury (ALI ) is an important cause of pulmonary hemorrhage of the newborn (PHN) and that surfactant protein A (SP-A) and tumor necrosis factor-α (TNF-α) are involved in the development of ALI. This study examined the levels of SPA and TNF-α in bronchoalveolar lavage fluid (BALF) and their relationship in newborns with pulmonary hemorrhage(PH). METHODS: Twenty newborn infants with PH and 15 sick neonates but without PH (Control group) were enrolled in this study. According to the prognosis, the PH group was subdivided into Survival group (n=14) and Death group (n=6). The Western-dot blot analysis and enzyme-linked immunoadsorbent assay (ELISA) were used to detect the levels of SP-A and TNF-α in BALF and serum TNF-α level. RESULTS: The SP-A levels in BALF in the survival PH patients in the acute stage and in the death PH cases were significantly lower than those of the Control group. The death PH patients showed a much lower SP-A level in BALF than the survival ones in the acute stage. Whilst the recovery stage of PH, the SP-A level in BALF in the survival patients increased significantly and remained the similar level as the Control group. The TNF-α levels in both serum and BALF in the survival PH patients in the acute stage and in the death PH cases were significantly higher than those in the Control group. The death PH cases showed a higher level of TNF-α in serum and BALF than PH survival cases in the acute stage. The increased extent of TNF-α level in BALF was obviously greater than of that in serum. In the recovery stage, the level of TNF-α in BALF was significantly reduced and almost returned to the level of the Control group in the survival PH cases compared with that in the acute stage. There was a negative correlation between the BALF SP-A and TNF-α levels in newborns with PH (r = - 0.635,P = 0.003). CONCLUSIONS: SP-A and TNF-α may be involved in the process of lung injury in PHN. Monitoring the levels of SP-A and TNF-α is useful for the early diagnosis and treatment and the evaluation of the outcome of PHN.
CAI Xu-Xu,MAO Jian,XIN Ying et al. Levels of surfactant protein A and TNF-α in bronchoalveolarlavage fluid of newborns with pulmonary hemorrhage[J]. CJCP, 2005, 7(3): 198-201.
