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Inflammation and the Insulin-like Growth Factor System at Very Preterm Birth. Implications for Early Morbidity and Development.

Pupp, Ingrid LU (2008) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2008:38.
Abstract
The intention of this thesis was to evaluate the effects of inflammation at very preterm birth on subsequent morbidity, as well as on the neuro-protective IGF-system. Prospective clinical studies of very preterm infants constituted a base for the evaluation. Temporal changes in levels of cytokines were chosen as markers of an induced inflammatory response and were evaluated together with components of the IGF-system at birth and during the first 3 postnatal days. The studies could describe associations between increased levels of pro-inflammatory cytokines and subsequent morbidity. Inflammation present in cord blood related to impaired developmental outcome at 2 years of age, as well as to changes in components of the IGF-system, which... (More)
The intention of this thesis was to evaluate the effects of inflammation at very preterm birth on subsequent morbidity, as well as on the neuro-protective IGF-system. Prospective clinical studies of very preterm infants constituted a base for the evaluation. Temporal changes in levels of cytokines were chosen as markers of an induced inflammatory response and were evaluated together with components of the IGF-system at birth and during the first 3 postnatal days. The studies could describe associations between increased levels of pro-inflammatory cytokines and subsequent morbidity. Inflammation present in cord blood related to impaired developmental outcome at 2 years of age, as well as to changes in components of the IGF-system, which indicates that inflammation present already before delivery may injure the immature brain and interfere with neuro-protective mechanisms. A postnatal increase in cytokines was on the other hand associated with early morbidity, such as arterial hypotension and cerebral hemorrhage. Concentrations of IGF-I displayed a temporal decrease from birth and onwards, suggesting a low endogenous production after very preterm birth. We could show that exogenous administration of IGF-I from adult donor plasma elevated low endogenous levels of IGF-I in extremely preterm infants without any side effects. In summary, these findings imply that the time point of an induced inflammatory response appears important for type of subsequent morbidity. This may be of relevance for determining an optimal time point of delivery and for intervention with anti-inflammatory or protective strategies, with the purpose to decrease brain injury after very preterm birth. (Less)
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author
supervisor
opponent
  • Prof Greisen, Gorm, Department of Gynaecology, Obstetrics and Paediatrics , University of Copenhagen, Denmark
organization
publishing date
type
Thesis
publication status
published
subject
keywords
cord blood, brain injury, cytokines, cerebral palsy, child development, fresh frozen plasma, inflammation, preterm birth, insulin-like growth factor I
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2008:38
pages
175 pages
publisher
Lund University, Faculty of Medicine
defense location
Rune Grupp salen, BMC, Sölvegatan 19, Lund
defense date
2008-04-25 13:00
ISSN
1652-8220
ISBN
978-91-85897-91-9
language
English
LU publication?
yes
id
c6dd0657-40be-4084-af08-6593a553cb58 (old id 1053544)
date added to LUP
2008-04-02 09:40:13
date last changed
2016-09-19 08:44:50
@phdthesis{c6dd0657-40be-4084-af08-6593a553cb58,
  abstract     = {The intention of this thesis was to evaluate the effects of inflammation at very preterm birth on subsequent morbidity, as well as on the neuro-protective IGF-system. Prospective clinical studies of very preterm infants constituted a base for the evaluation. Temporal changes in levels of cytokines were chosen as markers of an induced inflammatory response and were evaluated together with components of the IGF-system at birth and during the first 3 postnatal days. The studies could describe associations between increased levels of pro-inflammatory cytokines and subsequent morbidity. Inflammation present in cord blood related to impaired developmental outcome at 2 years of age, as well as to changes in components of the IGF-system, which indicates that inflammation present already before delivery may injure the immature brain and interfere with neuro-protective mechanisms. A postnatal increase in cytokines was on the other hand associated with early morbidity, such as arterial hypotension and cerebral hemorrhage. Concentrations of IGF-I displayed a temporal decrease from birth and onwards, suggesting a low endogenous production after very preterm birth. We could show that exogenous administration of IGF-I from adult donor plasma elevated low endogenous levels of IGF-I in extremely preterm infants without any side effects. In summary, these findings imply that the time point of an induced inflammatory response appears important for type of subsequent morbidity. This may be of relevance for determining an optimal time point of delivery and for intervention with anti-inflammatory or protective strategies, with the purpose to decrease brain injury after very preterm birth.},
  author       = {Pupp, Ingrid},
  isbn         = {978-91-85897-91-9},
  issn         = {1652-8220},
  keyword      = {cord blood,brain injury,cytokines,cerebral palsy,child development,fresh frozen plasma,inflammation,preterm birth,insulin-like growth factor I},
  language     = {eng},
  pages        = {175},
  publisher    = {Lund University, Faculty of Medicine},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {Inflammation and the Insulin-like Growth Factor System at Very Preterm Birth. Implications for Early Morbidity and Development.},
  volume       = {2008:38},
  year         = {2008},
}