Effect of therapeutic hypothermia on surfactant proteins, anti-inflammatory and pro-fibrotic mediators

Abstract

Objectives To study the effect of hypothermia on surfactant proteins, anti-inflammatory and pro-fibrotic mediators

Design Prospective, pragmatic study enrolling asphyxiated neonates without lung injury. Surfactant proteins (SP), Club cell secretory protein (CC-10), tumor growth factor-β1 (TGF-β1), human fibroblast growth factor-2 (hFGF) and anti-inflammatory interleukins (IL) were measured in broncho-alveolar lavage fluids obtained before, during and after hypothermia.

Results Twelve neonates were studied. SP-A, -B, -C, -D and CC-10 levels were similar before, during and after hypothermia. IL-10, IL-13, IL-14 were inconsistently detected only in five out of twelve patients and not in all timepoints; TGF-β1 was always undetectable. hFGF decreased during hypothermia (pre = 92 [52–193.6], during = 19.4 [0–42.6], post = 31.8 [0–83] ng/mL, p = 0.026) with levels before hypothermia being significantly higher than those obtained during and after the treatment (post hoc p = 0.025).

Conclusions In cooled neonates without any lung disorder, hypothermia is associated with lower hFGF but not with any changes in surfactant proteins or anti-inflammatory molecules.