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High Concentrations of Keratinocyte Growth Factor in Airways of Premature Infants Predicted Absence of Bronchopulmonary Dysplasia

Unité de réanimation néonatale, Centre Hospitalier Intercommunal de Créteil, Créteil; Service de Réanimation néonatale, Hôpital Cochin-Port Royal, Paris; and INSERM U492, Faculté de Médecine de Créteil, Créteil, France

Correspondence and requests for reprints should be addressed to Christophe Delacourt, Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000 Créteil, France. E-mail: christophe.delacourt{at}chicreteil.fr

Premature lungs are highly susceptible to lung injuries, leading to bronchopulmonary dysplasia (BPD). Keratinocyte growth factor (KGF) is produced by the developing lung and may reduce the risk of BPD by preventing injury to the lung epithelium and enhancing its repair. To determine whether KGF concentrations in the airways during the initial phase of hyaline membrane disease are correlated with subsequent development of BPD defined as the need for supplemental oxygen at a postconceptional age of 36 weeks, we obtained tracheal aspirates within 3 hours of birth (Day 0) from 91 intubated neonates with a gestational age of 30 weeks or less. Repeat samples were obtained from 42 neonates within 5 days after birth. KGF in aspirate supernatants was measured by enzyme-linked immunosorbent assay. On Day 0, KGF was detected in all but six neonates. A significant increase in KGF concentration was found from the first to the second samples. The highest KGF concentration within 5 days after birth (KGF_max) was significantly higher in survivors without BPD than in those with BPD. A KGF_max value higher than 110 pg/ml had a positive predictive value of 95% for absence of BPD. KGF may hold promise for the treatment of very premature neonates.

Key Words: lung development • newborn • bronchopulmonary dysplasia

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