Blood eosinophils, leukotriene C4 generation, and bronchial hyperreactivity in formerly preterm infants.

Infants born prematurely are known to display longstanding bronchial hyperreactivity. The mechanism responsible for this is still unclear. Eosinophils are thought to play a central part in the development of bronchial hyperreactivity in asthma. It was the aim of this study to assess the relation of bronchial hyperresponsiveness to potential markers of eosinophilic inflammation in peripheral blood. Eosinophil count, the concentration of serum eosinophilic cationic protein, the capacity of purified eosinophils to generate leukotriene C4, and bronchial reactivity was studied in 24 non-atopic children born prematurely, 12 healthy controls, and 12 children with asthma aged 6 to 9 years. There was no difference in serum concentrations on eosinophil cationic protein and eosinophil counts. However, eosinophils from the 15 formerly preterm infants with significant bronchial hyperreactivity generated significantly higher amounts of leukotriene C4 than normal controls and prematurely born children without bronchial hyperreactivity. Levels of leukotriene C4 in this group were comparable with those obtained with eosinophils from patients with asthma. In contrast with cells from the other groups, eosinophils from the children with bronchial hyperreactivity born prematurely show no enhancement of leukotriene C4 generation on prestimulation with platelet activating factor. It is concluded that bronchial hyperreactivity of children born prematurely is accompanied by the prestimulation of eosinophils.