Inhaled corticosteroid therapy reduces cytokine levels in sputum from very preterm infants with chronic lung disease


Takashi Ichiyama, Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
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Aim: To evaluate the effects of inhaled corticosteroid therapy and high-frequency oscillatory ventilation (oscillation) on preterm infants with chronic lung disease (CLD).

Methods: Ten infants with CLD who received inhaled corticosteroid therapy were enrolled. Week 1 was defined as the first week of therapy. The concentrations of interleukin (IL)-8, tumour necrosis factor-α (TNF-α), IL-1β, IL-6, IL-10 and IL-12p70 in serial sputum specimens from the infants were determined using a cytometric bead array.

Results: The sputum concentrations of IL-8 obtained from the infants during week 3–4 were significantly lower than those obtained before therapy and during week 1–2. The sputum concentrations of TNF-α, IL-6 and IL-10 during week 3–4 were significantly lower than the concetrations during week 1–2. The ratio of IL-8 levels during week 1–2 to those before therapy in infants who received oscillation (n = 4) was significantly lower than in those who received intermittent mandatory ventilation (n = 6).

Conclusion: Inhaled corticosteroids may be associated with a decrease in pro-inflammatory cytokine levels in sputum from infants with CLD from 2 weeks after the start of therapy. Our further investigations suggest that therapy with oscillation modulated airway inflammation earlier than therapy with intermittent mandatory ventilation.