Blood cytokines and BPD

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Inflammation is considered central to the pathogenesis of the bronchopulmonary dysplasia (BPD) that develops in very preterm infants. Indicators of lung inflammation prior to delivery (chorioamnionitis) and after delivery (oxygen exposure, mechanical ventilation, postnatal sepsis) correlate with the development of BPD. However, these correlations are not consistent across different reports, probably due to the nature, duration, and magnitudes of the various inflammatory exposures are imprecisely known or measured. Although the report by Paananen et al does not solve that problem, the results do indicate how complicated the associations can be. If the infant was exposed to chorioamnionitis, cytokine levels decreased after birth, even though the same cytokines increased in blood from infants not exposed to chorioamnionitis. At 1 day of age, blood levels of the pro-inflammatory cytokine IL-8, the growth factor G-CSF, and the anti-inflammatory cytokine IL-10 did correlate with the development of BPD. These observations do provide some insight into the pathogenesis of BPD, but cytokine measurements are not practical as clinical predictors of this complex and multifactorial disease.