4.4 Article

Milk Protein and Oil-Red-O Staining of Alveolar Macrophages in Chronic Respiratory Disease of Infancy

Journal

PEDIATRIC PULMONOLOGY
Volume 45, Issue 12, Pages 1213-1219

Publisher

WILEY
DOI: 10.1002/ppul.21310

Keywords

aspiration; wheezing; gastro-esophageal reflux; laryngomalacia; tracheomalacia; Oil-Red-O staining.

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Aspiration is a suspected cause of chronic respiratory disease in infants. We assessed the probability of aspiration by immunocytochemical staining of alveolar macrophages for milk proteins (a-lactalbumin and beta-lactoglobulin) and compared these findings with the Oil-Red-O staining score. Broncho-alveolar lavage (BAL), 24-hr esophageal pH-measurement and/or gastroesophageal scintigraphy were performed in 111 children. Seventy-nine patients were enrolled. Ten exclusively soya milk formula fed children served as a control group. Individual scores, expressed as the mean percentage of positive staining macrophages counted by three blinded authors were made. Relying on the control group, a positive score was defined as a value higher than 1%. A positive score was found in 26% (18/69). Forty-four percent (8/18) of them had positive gastroesophageal reflux (GER) tests. In 61% (11/18) a concomitant diagnosis of laryngo-/tracheomalacia was made. A positive score was found in 48% (11/23) of patients with laryngo-/tracheomalacia, compared to 15% (7/46) in infants with normal laryngeal and tracheal anatomy. No correlation was found between the immunocytochemical staining score for milk proteins and the Oil-Red-O staining score. We conclude that assuming the 1% criterion, persistent respiratory symptoms were associated with a positive immunostaining score, suggestive for aspiration, in 26% of infants, in 48% in case of concomitant laryngo- and/or tracheomalacia and in 15% of infants with normal laryngeal and tracheal anatomy No correlation was found between the immunocytochemical staining score for cow milk proteins and the Oil-Red-O staining score. Pediatr Pulmonol. 2010; 45:1213-1219. (C) 2010 Wiley-Liss, Inc.

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