Sudden Infant Death Syndrome Research Today is a free monthly online journal that collates and summarizes the latest research about Sudden Infant Death Syndrome, including details on sids, causes, prevention, statistics. | ||||||||
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Post-Neonatal drop in alveolar SP-A expression: Biological significance for increased vulnerability to SIDS?Stray-Pedersen A, Vege A, Stray-Pedersen A, Holmskov U, Rognum TO Institute of Forensic Medicine, University of Oslo, Rikshospitalet, Oslo, Norway. BACKGROUND: Surfactant protein A (SP-A) is synthesized in the lung and is a part of the innate immune system. The aim of this study was to evaluate the expression of SP-A in lung tissue from fetuses, infants, children and adults with special regard to sudden infant death syndrome (SIDS). METHODS: A total of 160 cases were studied; 19 fetuses and neonates, 59 SIDS and 49 explained infant deaths below 1 year of age, 19 toddlers and 14 adults. Immunohistochemical detection of SP-A using monoclonal antibodies was performed by microscopy of lung tissue specimens collected at autopsy. A scoring system was developed enabling semi-quantitative estimation of staining intensity and distribution. RESULTS: SP-A was detected in the terminal bronchioles and alveolar spaces of fetuses >35 weeks gestation. The intra-alveolar SP-A expression increased in the perinatal period followed by a marked drop in infants aged between 1 week and 5 months. Infants aged >5 months had abundant SP-A expression corresponding to older children and adults. There was no difference in the age distribution between cases of SIDS and explained deaths. CONCLUSIONS: The apparent drop in SP-A expression takes place in the first months after birth, corresponding with the classical age peak of SIDS. We therefore hypothesize that low expression of SP-A may be related in some as-yet undetermined way to the increased risk of SIDS at that age. Pediatr Pulmonol. 2008; 43:160-168. (c) 2007 Wiley-Liss, Inc. Published 2 January 2008 in Pediatr Pulmonol, 43(2): 160-8.
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