Cromolyn Sodium Prophylaxis Inhibits Pulmonary Proinflammatory Cytokines in Infants at High Risk for Bronchopulmonary Dysplasia

An imbalance of proinflammatory cytokines such as TNF- α , IL-1 β , and the neutrophil chemotactic factor IL-8 and inhibitors (e.g., soluble TNF receptors and IL-1ra) in the lung during the first week of life may contribute to prolonged pulmonary inflammation and fibrosis in bronchopulmonary dysplasia (BPD). Disodium cromoglycate (DSCG) has anti-inflammatory effects in asthma, a disease with many similarities with BPD. In a prospective, randomized, blinded study, we examined whether early DSCG therapy inhibits proinflammatory cytokines in infants at risk for BPD. Twenty-six infants who were identified as high risk ( ⩾ 75% probability) for oxygen-dependency at 28 d by a 12-h predictive score and survived 48 h were randomized to nebulized DSCG 20 mg (n = 13) or 2 cc NS (control, n = 13) every 6 h from Day 3 to Day 28. Lung lavage was collected on Day 3 (pre-study) and Day 7 and analyzed for cell count and differential and TNF- α , sTNFR1, sTNFR2, IL-1 β , IL-1ra, and IL-8 concentrations. The groups' pre-stu...