Sustained sterile inflammation is related to pulmonary morbidities in premature infants

Abstract

Objective

Sterile inflammation, initiated by endogenous molecules such as high-mobility group box-1 (HMGB1), has come to be recognized as a critical mechanism in a variety of chronic diseases. To elucidate the involvement of sterile inflammation in neonatal disease, the association between serum HMGB1 levels and the development of bronchopulmonary dysplasia (BPD) was evaluated.

Study design

Serum HMGB1 levels were measured in 25 premature infants born before 33 weeks of gestation, excluding any infection cases. Samples were collected at birth, two, and four weeks of age and compared according to BPD status.

Results

The serum HMGB1 levels in infants with BPD were maintained up to 4 weeks of age, while those without BPD declined with time. Postnatal cardiopulmonary and nutritional transition was delayed in infants with BPD.

Conclusion

Sustained elevation of serum HMGB1 levels was associated with the development of BPD, suggesting that prolonged sterile inflammation may contribute to lung injury.

Keywords:

• Sterile inflammation
• high-mobility group-box 1 (HMGB1)
• bronchopulmonary dysplasia

Authors’ contributions

YS was involved in study design and data interpretation. YS and SK were involved in the sample collection. YS and YN were involved in the data analysis. All authors critically revised the report, commented on draft of the manuscript, and approved the final report.

Acknowledgements

The authors express appreciation to the staff members at the NICU of Japanese Red Cross Maternity Hospital for dedicating special care to the infants in this study. We wish to thank Enago (www.enago.jp) for the English language review.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI [grant number 19K08331].