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Length of gestation period linked to chronic lung disease
SCIENCE AND MEDICINE
Length of gestation period linked to chronic lung disease with non-pulmonary complications. All neonates studied were mechanically ventilated at birth.
Rights were not granted to include this image in electronic media. Please refer to the printed journal. Preterm infant with respiratory problems
The group measured the concentrations of EGF, a factor involved in normal lung development and maturation of epithelial cells in the later stages of pregnancy, and vascular endothelial growth factor (VEGF). VEGF has a role in vascular maturation and is probably important in the repair of damaged lungs. The researchers then assessed the relation between EGF and VEGF, and birthweight and gestational age (Eur Respir J 2001; 18: 1–5).
Science Photo Library
K researchers have found a relation between the concentration of epidermal growth factor (EGF), associated with development of chronic lung disease in preterm infants, and gestational age. The researchers suggest that EGF “is closely correlated to gestation and that it may predispose preterm infants to develop chronic lung disease”. These findings “add to the contributions already made by this group, which show that biochemical markers can predict which premature babies will get chronic lung disease”, comments Richard Auten (Duke University Medical Center, Durham, NC, USA). “These [markers] are sorely needed to design successful treatments aimed at the newborns at highest risk.” Sailesh Kotecha (University of Leicester, UK) and colleagues compared broncheoalveolar lavage fluid samples taken from 13 infants who developed chronic lung disease, with samples from 16 infants who developed and recovered from respiratory distress syndrome, and six controls
U
At birth, EGF was undetectable in infants who developed chronic lung disease, but present in both other groups. VEGF, however, was undetectable in all groups at birth. Children with chronic lung disease were born after an average gestation of 27 weeks and weighed an average of 820 g, whereas infants with respiratory distress syndrome that resolved were born after 31 weeks’ gestation, and were heavier at 1415 g. Concentrations of EGF and VEGF subsequently increased at varying rates. Only EGF was related to birthweight and age. Patricia Haslam (National Heart and Lung Institute, London, UK) told The Lancet: “In view of these findings, it seems reasonable to speculate that using surfactant therapy in combination with agents, such as corticosteroids or recombinant EGF to speed maturation of alveolar epithelial cells, might provide an improved therapeutic approach in the future for those infants at greatest risk of chronic lung disease.” Abigail Pound
US centres to study relation between environment and developmental disorders
F
our new US Children’s Environmental Health Centers are to be set up, the National Institute of Environmental Health Sciences (NIEHS) and the Environmental Protection Agency announced on Oct 25. The centres will focus their research on the effects of environmental pollutants on developmental disorders. The centres, which will receive funding of US$1 million per year for 5 years, join the eight other environmental health centres established in 1998. “Parents and professionals are thinking about vaccination and chemical exposure and are concerned about whether there is a link to developmental disorders”, comments Gwen Collman, from the NIEHS. “We felt there was a gap and that the current programmes didn’t really include research specifically looking at developmental disabilities.” Susan Schantz (University of Illinois, Urbana) will lead a project to examine the effect of combined exposure to two environmental contaminants—PCBs (polychlorinated biphenyls) and methyl mercury—on cognitive, sensory, and motor development in children. “These
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two contaminants often occur together in the environment, but there has been almost no research looking at the effects of combined exposure”, explains Schantz. Exposure to PCBs and methyl mercury usually occurs through eating contaminated fish, and the investigators will study a population of Hmong and Laotian refugees, who settled along the Great Lakes in Wisconsin. “Many families have been catching and eating large amounts of PCB- and methyl mercury-contaminated fish from a local river that was contaminated by paper mills in the area.” Bruce Lanphear (University of Cincinnati College of Medicine, OH) will head a project that aims to assess, and ultimately reduce, concentrations of lead, pesticides, and other environmental hazards in participants’ homes. The project aims to test tools that families can use to assess concentrations of contaminants in their home. Lanphear also highlights several other novel aspects of their project. These include studying the effects of lifetime exposure to lead on criminal behaviours and the effect of lead exposure on brain density, volume,
and functioning measured by magnetic resonance imaging (MRI) and fMRI. At the University of California at Davis, under the leadership of Isaac Pessah, researchers will be aiming to elucidate the environmental risk factors that contribute to the incidence and severity of childhood autism. As part of this work the investigators will be doing a large case-control study of various exposures to metals or chemicals and the development of autism. George Lambert (Robert Wood Johnson Medical School, NJ) and colleagues will examine the possible influence of mercury, lead, and valproic acid on autism. The investigators will study critical “windows” for brain development, with the aim of linking exposures at these times to subsequent behaviour. “Because each of these centres is working closely with communities to address their specific needs as well as working with the other centres to share information and experiences, I believe their impact will be substantial”, comments Schantz. Helen Frankish
THE LANCET • Vol 358 • November 3, 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Length of gestation period linked to chronic lung disease with non-pulmonary complications. All neonates studied were mechanically ventilated at birth.
Rights were not granted to include this image in electronic media. Please refer to the printed journal. Preterm infant with respiratory problems
The group measured the concentrations of EGF, a factor involved in normal lung development and maturation of epithelial cells in the later stages of pregnancy, and vascular endothelial growth factor (VEGF). VEGF has a role in vascular maturation and is probably important in the repair of damaged lungs. The researchers then assessed the relation between EGF and VEGF, and birthweight and gestational age (Eur Respir J 2001; 18: 1–5).
Science Photo Library
K researchers have found a relation between the concentration of epidermal growth factor (EGF), associated with development of chronic lung disease in preterm infants, and gestational age. The researchers suggest that EGF “is closely correlated to gestation and that it may predispose preterm infants to develop chronic lung disease”. These findings “add to the contributions already made by this group, which show that biochemical markers can predict which premature babies will get chronic lung disease”, comments Richard Auten (Duke University Medical Center, Durham, NC, USA). “These [markers] are sorely needed to design successful treatments aimed at the newborns at highest risk.” Sailesh Kotecha (University of Leicester, UK) and colleagues compared broncheoalveolar lavage fluid samples taken from 13 infants who developed chronic lung disease, with samples from 16 infants who developed and recovered from respiratory distress syndrome, and six controls
U
At birth, EGF was undetectable in infants who developed chronic lung disease, but present in both other groups. VEGF, however, was undetectable in all groups at birth. Children with chronic lung disease were born after an average gestation of 27 weeks and weighed an average of 820 g, whereas infants with respiratory distress syndrome that resolved were born after 31 weeks’ gestation, and were heavier at 1415 g. Concentrations of EGF and VEGF subsequently increased at varying rates. Only EGF was related to birthweight and age. Patricia Haslam (National Heart and Lung Institute, London, UK) told The Lancet: “In view of these findings, it seems reasonable to speculate that using surfactant therapy in combination with agents, such as corticosteroids or recombinant EGF to speed maturation of alveolar epithelial cells, might provide an improved therapeutic approach in the future for those infants at greatest risk of chronic lung disease.” Abigail Pound
US centres to study relation between environment and developmental disorders
F
our new US Children’s Environmental Health Centers are to be set up, the National Institute of Environmental Health Sciences (NIEHS) and the Environmental Protection Agency announced on Oct 25. The centres will focus their research on the effects of environmental pollutants on developmental disorders. The centres, which will receive funding of US$1 million per year for 5 years, join the eight other environmental health centres established in 1998. “Parents and professionals are thinking about vaccination and chemical exposure and are concerned about whether there is a link to developmental disorders”, comments Gwen Collman, from the NIEHS. “We felt there was a gap and that the current programmes didn’t really include research specifically looking at developmental disabilities.” Susan Schantz (University of Illinois, Urbana) will lead a project to examine the effect of combined exposure to two environmental contaminants—PCBs (polychlorinated biphenyls) and methyl mercury—on cognitive, sensory, and motor development in children. “These
1518
two contaminants often occur together in the environment, but there has been almost no research looking at the effects of combined exposure”, explains Schantz. Exposure to PCBs and methyl mercury usually occurs through eating contaminated fish, and the investigators will study a population of Hmong and Laotian refugees, who settled along the Great Lakes in Wisconsin. “Many families have been catching and eating large amounts of PCB- and methyl mercury-contaminated fish from a local river that was contaminated by paper mills in the area.” Bruce Lanphear (University of Cincinnati College of Medicine, OH) will head a project that aims to assess, and ultimately reduce, concentrations of lead, pesticides, and other environmental hazards in participants’ homes. The project aims to test tools that families can use to assess concentrations of contaminants in their home. Lanphear also highlights several other novel aspects of their project. These include studying the effects of lifetime exposure to lead on criminal behaviours and the effect of lead exposure on brain density, volume,
and functioning measured by magnetic resonance imaging (MRI) and fMRI. At the University of California at Davis, under the leadership of Isaac Pessah, researchers will be aiming to elucidate the environmental risk factors that contribute to the incidence and severity of childhood autism. As part of this work the investigators will be doing a large case-control study of various exposures to metals or chemicals and the development of autism. George Lambert (Robert Wood Johnson Medical School, NJ) and colleagues will examine the possible influence of mercury, lead, and valproic acid on autism. The investigators will study critical “windows” for brain development, with the aim of linking exposures at these times to subsequent behaviour. “Because each of these centres is working closely with communities to address their specific needs as well as working with the other centres to share information and experiences, I believe their impact will be substantial”, comments Schantz. Helen Frankish
THE LANCET • Vol 358 • November 3, 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.