Susceptibility to <Emphasis Type="Italic">Yersinia pestis</Emphasis> Experimental Infection in Wild <Emphasis Type="Italic">Rattus rattus</Emphasis>, Reservoir of Plague in Madagascar

In Madagascar, the black rat, Rattus rattus, is the main reservoir of plague (Yersinia pestis infection), a disease still responsible for hundreds of cases each year in this country. This study used experimental plague challenge to assess susceptibility in wild-caught rats to better understand how R. rattus can act as a plague reservoir. An important difference in plague resistance between rat populations from the plague focus (central highlands) and those from the plague-free zone (low altitude area) was confirmed to be a widespread phenomenon. In rats from the plague focus, we observed that sex influenced plague susceptibility, with males slightly more resistant than females. Other individual factors investigated (weight and habitat of sampling) did not affect plague resistance. When infected at high bacterial dose (more than 10⁵ bacteria injected), rats from the plague focus died mainly within 3–5 days and produced specific antibodies, whereas after low-dose infection (< 5,000 bacteria), delayed mortality was observed and surviving seronegative rats were not uncommon. These results concerning plague resistance level and the course of infection in the black rat would contribute to a better understanding of plague circulation in Madagascar.     

The epizootiological significance of flea accumulation in aggregations of the female long-tailed suslik in the Tuva plague focus

The formation of aggregations of related females is a peculiarity of the intrapopulational organization of long-tailed suslik that results in the accumulation of Citellophilus tesquorum, the main vector and keeper of the plague microbe in the Tuva plague nidus. The plague agent is adapted to the existence on the territory occupied by aggregations of females that manifests itself in the delay of the beginning and prolixity of block-formation periods in fleas. The transfer of the agent from one place to another takes place only at the high abundance of long-tailed suslik. When the number of the suslik is low the plague microbe circulates in the ranges of one or several neighbouring aggregations of females having no possibility for successful transfer to a new place.     

Testing the Generality of a Trophic-cascade Model for Plague

Climate may affect the dynamics of infectious diseases by shifting pathogen, vector, or host species abundance, population dynamics, or community interactions. Black-tailed prairie dogs (Cynomys ludovicianus) are highly susceptible to plague, yet little is known about factors that influence the dynamics of plague epizootics in prairie dogs. We investigated temporal patterns of plague occurrence in black-tailed prairie dogs to assess the generality of links between climate and plague occurrence found in previous analyses of human plague cases. We examined long-term data on climate and plague occurrence in prairie dog colonies within two study areas. Multiple regression analyses revealed that plague occurrence in prairie dogs was not associated with climatic variables in our Colorado study area. In contrast, plague occurrence was strongly associated with climatic variables in our Montana study area. The models with most support included a positive association with precipitation in April–July of the previous year, in addition to a positive association with the number of “warm” days and a negative association with the number of “hot” days in the same year as reported plague events. We conclude that the timing and magnitude of precipitation and temperature may affect plague occurrence in some geographic areas. The best climatic predictors of plague occurrence in prairie dogs within our Montana study area are quite similar to the best climatic predictors of human plague cases in the southwestern United States. This correspondence across regions and species suggests support for a (temperature-modulated) trophic-cascade model for plague, including climatic effects on rodent abundance, flea abundance, and pathogen transmission, at least in regions that experience strong climatic signals.     

Spatial and temporal distribution of Antarctic fur seals (Arctocephalus gazella) on the breeding grounds at Bird Island,South Georgia

Summary The number of Antarctic fur seals (Arctocephalus gazella) in the area of the Scotia Sea has been increasing. Observation of their distribution on the breeding grounds are important to help design and interpret censuses. These seals are highly polygynous. In the study area at Bird Island, South Georgia, females give birth and are mated in densely packed colonies located along the shore close to the tideline. Males establish territories in this area, but are also found further inland. This study examined the density-dependent processes regulating the instantaneous size of the male breeding population; the distribution of males in relation to space and the number of females available to be mated and the effect of gregarious behaviour of females on male dispersion. Males were only territorial on the beaches in the areas where most females gave birth and subsequently had their post-partum oestrus. There was an apparent lower (19–20 m²) and upper (40 m²) limit to territory size. Males were excluded from the beach areas when the average density on the beaches was greater than 5 males per 200 m². An asymptotic density of 10–11 males per 200 m² was reached on the beaches and 4–5 males per 200 m² elsewhere. These two asymptotic densities may represent the upper and lower limits of density for a territorial system of dispersion. A model of the temporal changes in female numbers suggested that the total number of females occupying an area of beach during the mating period was approximately twice the number at the peak of the season. There was no indication that males compensated for low female density by increasing territory size. Females and pups became more dispersed after the end of the mating period. It is suggested that one function of gregariousness in females is as a mechanism for mate selection. This study also has implications for methods used to measure population size.     

The epizootiological role of the population organization of the stock of fleas on the long-tailed suslik in a natural focus of plague in Tuva

Spatial location of epizootic events in the Tuva plague focus is determined at a considerable degree by the population structure of the flea Citellophilus tesquorum--the main plague microbe vector. Within the enzootic territory occupied by five populations of the long-tailed ground squirrel (Citellus undulatus) there are six populations of C. tesquorum. Each population of fleas has a corresponding autonomic plague focus. Various conditions for the microbe life activity in these populations are recovered. The circulation of the microbe is closely connected with certain intrapopulation groupings of fleas--the nuclei of populations.     

Mortality Risk and Survival in the Aftermath of the Medieval Black Death

The medieval Black Death (c. 1347-1351) was one of the most devastating epidemics in human history. It killed tens of millions of Europeans, and recent analyses have shown that the disease targeted elderly adults and individuals who had been previously exposed to physiological stressors. Following the epidemic, there were improvements in standards of living, particularly in dietary quality for all socioeconomic strata. This study investigates whether the combination of the selective mortality of the Black Death and post-epidemic improvements in standards of living had detectable effects on survival and mortality in London. Samples are drawn from several pre- and post-Black Death London cemeteries. The pre-Black Death sample comes from the Guildhall Yard (n = 75) and St. Nicholas Shambles (n = 246) cemeteries, which date to the 11^th–12^th centuries, and from two phases within the St. Mary Spital cemetery, which date to between 1120-1300 (n = 143). The St. Mary Graces cemetery (n = 133) was in use from 1350–1538 and thus represents post-epidemic demographic conditions. By applying Kaplan-Meier analysis and the Gompertz hazard model to transition analysis age estimates, and controlling for changes in birth rates, this study examines differences in survivorship and mortality risk between the pre- and post-Black Death populations of London. The results indicate that there are significant differences in survival and mortality risk, but not birth rates, between the two time periods, which suggest improvements in health following the Black Death, despite repeated outbreaks of plague in the centuries after the Black Death.     

Paläogenetik der Pest

Paleogenetics of the plague Plague has been part of our history since ancient times. Introduced again and again to Europe over centuries, the 'pestilences' killed millions of people before disappearing from the continent in 19^th Century. In the Middle Ages, bacteria were unknown and often the transmission routes of plague remained unrecognized. Plague was considered as a punishment by God disseminated by Miasma. With modern methods, microbiologists and palaeogenetists have now successfully shown that all the three historical recognized plague pandemics indeed were caused by the bacterium Yersinia pestis. In addition, important information has been obtained about the evolution of the bacterium and its origin. New data from ongoing studies on victims of the past epidemics help to shed new light on the past and perhaps even on the present of plague.     

Distribution of surnames and linguistic-cultural identities in Western Slovenia

The following study compares the distribution of surnames in the populations of Western Slovenian municipalities, which were part of the Italian state until the end of the Second World War. The analyses have been carried out firstly by assessing the similarity of different populations to one another so as to verify possible aggregations; secondly, by figuring these relationships of similarity in a representation through unrooted tree (NJ); finally, by applying spatial autocorrelation to the distribution of surnames in the territory so as to highlight possible processes in the diffusion of people in the area under examination. On the whole, it seems likely that the population living in the area is geographically quite stable, although some differences may be noted depending both on the geography of the territory, particularly in the northern part, and on peculiar historical and socioeconomic conditions, which at the same time have characterized and modified the demographic structure of some of these municipalities.     

Several principles for epidemiologic evaluation of individual regions of the Trans-Caucasian plains-piedmont natural focus of plague]

The authors analyse many-year data concerning the epizootological study of seven landscape-geographical regions of the Eastern Transcaucasus differing by natural conditions and the enzootic intensity. Quantitative assessment of natural nidality determined by the level (norm) of many-year indices calculated for the years of 1955--1974 are presented for each region. Flea vectors were more numerous in localities of stable enzootic manifestation; also the numbers of Meriones erythrourus (carrier rodent) was more stable than in the regions of temporary occurrence of the causative agent and those free of plague. Many-year level of the flea (X. conformis) abundance index equal to one served as the threshold value determining the territory enzooticity.     

Multi-scale habitat selection in highly territorial bird species: Exploring the contribution of nest,territory and landscape levels to site choice in breeding rallids (Aves: Rallidae)

Habitat selection often involves choices made at different spatial scales, but the underlying mechanisms are still poorly understood, and studies that investigate the relative importance of individual scales are rare. We investigated the effect of three spatial scales (landscape, territory, nest-site) on the occurrence pattern of little crake Zapornia parva and water rail Rallus aquaticus at 74 ponds in the Masurian Lakeland, Poland. Habitat structure, food abundance and water chemical parameters were measured at nests and random points within landscape plots (from 300-m to 50-m radius), territory (14-m) and nest-site plots (3-m). Regression analyses suggested that the most relevant scale was territory level, followed by landscape, and finally by nest-site for both species. Variation partitioning confirmed this pattern for water rail, but also highlighted the importance of nest-site (the level explaining the highest share of unique variation) for little crake. The most important variables determining the occurrence of both species were water body fragmentation (landscape), vegetation density (territory) and water depth (at territory level for little crake, and at nest-site level for water rail). Finally, for both species multi-scale models including factors from different levels were more parsimonious than single-scale ones, i.e. habitat selection was likely a multi-scale process. The importance of particular spatial scales seemed more related to life-history traits than to the extent of the scales considered. In the case of our study species, the territory level was highly important likely because both rallids have to obtain all the resources they need (nest site, food and mates) in relatively small areas, the multi-purpose territories they defend.     

Dispersal of the flea Ctenophyllus hirticrus and spreading of plague epizooties in Gorny Altai

Gradual dispersion of an abundant flea species Ctenophyllus hirticrus specific to the Pallas's pika (the main plague carrier), is revealed in the Gorno-Altai natural plague focus on the territory, occupied by two populations of this lagomorph. Spreading of Yersinia pestis in these areas took place a short time later the rise of this ectoparasite's abundance. It is supposed that the colonization of these areas by C. hirticrus was one of the factors determined epizooties spreading within the focus and formation of new sites of stable Y. pestis preservation.     

Big boys get big girls: Factors influencing pupping site and territory location in Australian fur seals

To examine the factors influencing birth site selection and territory location in Australian fur seals (Arctocephalus pusillus doriferus), habitat variables (slope, substrate, and elevation) were quantified in seven zones within a breeding colony on Kanowna Island (39º15′S, 146º18′E), southeastern Australia. Distribution across the colony was not uniform with zones at low elevations (i.e., close to water) being preferred areas, having earlier occupancies and greater female densities. Body length of females and territorial adult males was assessed using laser‐metrics. Average female length increased throughout the breeding season, within zones and across the colony, with larger females arriving to give birth later. Larger females also occupied areas of lower elevation close to water. Adult male body length had no influence on territory size, but was positively correlated with the number of females in harems (r² = 0.70, P < 0.05) and female length (r² = 0.87, P < 0.01) within harems. By monopolizing larger females, adult males may enhance their reproductive success as these individuals are more likely to give birth and have greater weaning success.     

Yersinia pestis strains isolated in natural plague foci of Caucasus and Transcaucasia in the context of the global evolution of species

BackgroundPlague is a highly dangerous vector-borne infectious disease that has left a significant mark on history of humankind. There are 13 natural plague foci in the Caucasus, located on the territory of the Russian Federation, Azerbaijan, Armenia and Georgia. We performed whole-genome sequencing of Y. pestis strains, isolated in the natural foci of the Caucasus and Transcaucasia. Using the data of whole-genome SNP analysis and Bayesian phylogeny methods, we carried out an evolutionary-phylogeographic analysis of modern population of the plague pathogen in order to determine the phylogenetic relationships of Y. pestis strains from the Caucasus with the strains from other countries.ResultsWe used 345 Y. pestis genomes to construct a global evolutionary phylogenetic reconstruction of species based on whole-genome SNP analysis. The genomes of 16 isolates were sequenced in this study, the remaining 329 genomes were obtained from the GenBank database. Analysis of the core genome revealed 3315 SNPs that allow differentiation of strains. The evolutionary phylogeographic analysis showed that the studied Y. pestis strains belong to the genetic lineages 0.PE2, 2.MED0, and 2.MED1. It was shown that the Y. pestis strains isolated on the territory of the East Caucasian high-mountain, the Transcaucasian high-mountain and the Priaraksinsky low-mountain plague foci belong to the most ancient of all existing genetic lineages - 0.PE2.ConclusionsOn the basis of the whole-genome SNP analysis of 345 Y. pestis strains, we describe the modern population structure of the plague pathogen and specify the place of the strains isolated in the natural foci of the Caucasus and Transcaucasia in the structure of the global population of Y. pestis. As a result of the retrospective evolutionary-phylogeographic analysis of the current population of the pathogen, we determined the probable time frame of the divergence of the genetic lineages of Y. pestis, as well as suggested the possible paths of the historical spread of the plague pathogen.     

Clinical and Pathologic Features of Cynomolgus Macaques (Macaca fascicularis) Infected with Aerosolized Yersinia pestis

Since the anthrax attacks of 2001, the emphasis on developing animal models of aerosolized select agent pathogens has increased. Many scientists believe that nonhuman primate models are the most appropriate to evaluate pulmonary response to, vaccines for, and treatments for select agents such as Yersinia pestis (Y. pestis), the causative agent of plague. A recent symposium concluded that the cynomolgus macaque (Macaca fascicularis) plague model should be characterized more fully. To date, a well-characterized cynomolgus macaque model of pneumonic plague using reproducible bioaerosols of viable Y. pestis has not been published. In the current study, methods for creating reproducible bioaerosols of viable Y. pestis strain CO92 (YpCO92) and pneumonic plague models were evaluated in 22 Indonesian-origin cynomolgus macaques. Five macaques exposed to doses lower than 250 CFU remained free of any indication of plague infection. Fifteen macaques developed fever, lethargy, and anorexia indicative of clinical plague. The 2 remaining macaques died without overt clinical signs but were plague-positive on culture and demonstrated pathology consistent with plague. The lethal dose of plague in humans is reputedly less than 100 organisms; in this study, 66 CFU was the dose at which half of the macaques developed fever and clinical signs (ED₅₀), The Indonesian cynomolgus macaque reproduces many aspects of human pneumonic plague and likely will provide an excellent model for studies that require a macaque model.Yersinia pestis is the causative agent of plague. Likely more people worldwide have died from Y. pestis infections than from any other single infectious disease.^26,27 Bubonic plague, the most common form of the disease, results when the bacterium is inoculated into the skin, typically by means of flea bites. The resulting cutaneous infection spreads to local lymph nodes; the swollen lymph nodes are known as bubos and often serve as a source of systemic infection. Although less common, the bacterium also can spread by aerosol, causing pneumonic plague. Pneumonic plague can result from pulmonary spread of systemic infection or from deliberate dissemination and is associated with nearly 100% human mortality if left untreated. Y. pestis is susceptible to commonly available antibiotics if treatment begins soon after infection. However, depending on the route of infection, the time at which infection is confirmed is often too late for antibiotics to prevent significant morbidity or mortality.¹⁰ Because pneumonic plague is the form most likely to be seen in bioterrorism events,¹⁶ interest in animal models has arisen to support development of vaccines and improved therapeutics.Potential vaccines and therapeutic agents for plague must protect against the pneumonic disease, but contemporary published data regarding disease pathogenesis using aerosolized Y. pestis pathogenesis in nonhuman primates are scant.^4,9,21,23,24 In the United States, when vaccine or antibiotic efficacy cannot be evaluated in humans, an animal species that is reasonably expected to recapitulate human disease must be used.⁹ For many biothreat agents such as plague, a nonhuman primate model often is required. Although some laboratories have examined the cynomolgus macaque model of aerosolized plague briefly,¹ no published reports fully characterize this model. Published studies have examined plague in the African green monkey or vervet (Chlorocebus spp., formerly Cercopithecus aethiops) and rhesus macaque (Macaca mulatta).¹ Vervets reportedly are more sensitive to plague than are macaques,^4,24 such that some vervets are susceptible to infection with vaccine strains, casting some doubt on applicability of this species for plague studies.¹ The disease in rhesus macaques differs from that in humans in that rhesus macaques frequently develop disseminated intravascular coagulation (DIC) and chronic pneumonia as a result of pneumonic plague while humans usually develop acute pneumonia without DIC.^1,7Many participants at a recent symposium sponsored by the Food and Drug Administration and National Institute of Allergy and Infectious Disease endorsed the development of a cynomolgus macaque pneumonic plague model to support plague therapeutic and vaccine studies.⁸ The current study was undertaken to evaluate the Indonesian cynomolgus macaque as a model of aerosolized Y. pestis Colorado 92 (YpCO92) for subsequent vaccine and therapeutic trials. We also sought to determine whether fever development could be used to determine a humane endpoint to the study, as an alternative to LD₅₀ methods.     

Comparing pellet and stable isotope analyses of nestling Bonelli's Eagle Aquila fasciata diet

Diet analyses are central to the study of avian trophic ecology, and stable isotope analyses have made an increasing contribution in the last two decades. Few isotopic studies have assessed the diet of raptor species, which are more frequently analysed by conventional diet methods such as pellet analysis. In this study, we compare prey consumption estimates of nestling Bonelli's Eagles Aquila fasciata from conventional pellet analysis (in terms of items and biomass) and stable isotopic mixing models (SIAR) using δ¹³C, δ¹⁵N and δ³⁴S of feathers. The pellet analysis showed that European Rabbits Oryctolagus cuniculus, pigeons (mainly Common Wood Pigeons Columba palumbus and Domestic Pigeons Columba livia dom.), Red‐legged Partridges Alectoris rufa, passerines, Yellow‐legged Gulls Larus michahellis and Eurasian Red Squirrels Sciurus vulgaris were the main prey, so they were selected for diet reconstructions in SIAR. At the population level, mean prey consumption estimates were similar for pellets (both items and biomass) and SIAR. At the territory level, the weighted kappa statistic showed good ordinal scale agreement in main prey consumption between items or biomass and SIAR. Although the intraclass correlation coefficient showed poor method agreement when considering all prey in the same analysis, the intraclass correlation coefficients for each prey category showed significant agreement between pellets and SIAR when estimating the consumption of Rabbits, pigeons and Gulls, with lower agreement for passerines and Squirrels. Lastly, there was poor method agreement for estimates of Partridges. Our results suggest an overall agreement between the pellet analysis and SIAR when estimating nestling Bonelli's Eagle diet at both the population and, to a lesser extent, the territory level, supporting the usefulness of isotopic mixing models when identifying the terrestrial and marine components of raptor diets.     

The Dynamics of Territory Acquisition: A Model of Two Coexisting Strategies

Two potential strategies for acquiring territories are (1) fighting and taking over a territory from its owner, or (2) waiting until a territory owner dies and then taking its place. In this paper we explore territory acquisition using these two strategies, using a population dynamical model. Factors expected to affect the predominance of each strategy are injury rate, rate of successful territory takeover, birth and death rates on the territory, and birth and death rates while non-territorial. We explore the effects of these parameters on numbers of territorial and nonterritorial fighters and waiters. Waiters predominate when injury rate, birth rate of nonterritorial individuals, and death rate of territory owners are high. Fighters predominate when rate of successful territory takeover, death rate of nonterritorial individuals, and birth rate of territory owners are high. We present supportive evidence for these preditions from the literature.     

Territory size of wolves Canis lupus: linking local (Białowieża Primeval Forest, Poland) and Holarctic-scale patterns

Factors affecting territory size in wolves Canis lupus were studied at 2 scales, the local population (Bia?owie?a Primeval Forest (BPF), eastern Poland) and the geographic range of species (literature review from 14 localities in the Holarctic). Four packs of wolves were studied by radio‐tracking in BPF from 1994 to 1999. The annual territories of packs (Minimum convex polygons with 95% of locations) averaged 201 km² (SD 63, range 116–310). Core areas of territories (50% MCP) covered from 14 to 78 km² (mean 35). Territory sizes and core areas both were negatively correlated to the encounter rates of ungulates (mean number of ungulates seen per unit time spent in the forest by human observers). Pack size (3–8 wolves) did not influence territory size. Home ranges of individual wolves from the same pack varied with season as well as the age, sex, and reproductive status of the wolf. Review of literature from North America and Europe (42–66^oN), showed that latitude and prey biomass were essential factors shaping the biogeographic variation in wolf territory size. Territories increased with latitude and declined with growing biomass of prey. The analysis showed that latitude acted partly independently of the south–north gradient in prey abundance. At similar standing crop of ungulate biomass (100 kg km^?2), wolf territories would average 140 km² at 40^oN, 370 km² at 50^oN, and 950 km² at 60^oN. Pack size was larger at northern latitudes, but the increase did not keep pace with enlargement of territories. Within‐territory density of wolves declined from 2.5–3 wolves 100 km^?2 at 40–45^oN to 0.7 wolves 100 km^?2 at 60^oN. Our analyses documented similarities regarding the role of prey resources in shaping wolf territoriality at the different scales. Furthermore, a macroecological approach revealed additional factors affecting wolf territory size that were not emergent from knowledge of local population.     

Dynamics of Yersinia pestis and Its Antibody Response in Great Gerbils (Rhombomys opimus) by Subcutaneous Infection

Background

Rhombomys opimus (great gerbil) is a reservoir of Yersinia pestis in the natural plague foci of Central Asia. Great gerbils are highly resistant to Y. pestis infection. The coevolution of great gerbils and Y. pestis is believed to play an important role in the plague epidemics in Central Asia plague foci. However, the dynamics of Y. pestis infection and the corresponding antibody response in great gerbils have not been evaluated. In this report, animal experiments were employed to investigate the bacterial load in both the liver and spleen of infected great gerbils. The dynamics of the antibody response to the F1 capsule antigen of Y. pestis was also determined.

Methodology

Captured great gerbils that tested negative for both anti-F1 antibodies and bacterial isolation were infected subcutaneously with different doses (10⁵ to 10¹¹ CFU) of a Y. pestis strain isolated from a live great gerbil during routine plague surveillance in the Junggar Basin, Xinjiang, China. The clinical manifestations, changes in body weight, anal temperature, and gross anatomy of the infected animals were observed. The blood cell count, bacterial load, and anti-F1 antibody titers were determined at different time points after infection using a blood analyzer, plate counts, and an indirect hemagglutination assay, respectively.

Conclusions/Significance

The dynamics of bacterial load and the anti-F1 antibody concentration in great gerbils are highly variable among individuals. The Y. pestis infection in great gerbils could persist as long as 15 days. They act as an appropriate reservoir for plague in the Junggar Basin, which is part of the natural plague foci in Central Asia. The dynamics of the Y. pestis susceptibility of great gerbil will improve the understanding of its variable resistance, which would facilitate the development of more effective countermeasures for controlling plague epidemics in this focus.     

Vasoactive intestinal peptide: levels and functional receptors in rat brain before and after weaning.

The average level of VIP was found to be 17 pmol/g wet weight in the brain of the newborn rat. This level ramained constant during the first two weeks after birth then increased progressively to 40 pmol/g wet weight at 20 days, a value comparable to that found in adult animals. VIP was already able to stimulate brain membrane adenylate cyclase activity at birth. The stimulation with 10^?6 M VIP allowed a 2.5-fold increase in basal activity in membranes from 1 to 14-days-old pups as compared to a 1.7-fold stimulation in membranes from adult brain. The apparent activation constant for VIP adenylate cyclase stimulation was 4.10^?7 M at all ages. The efficiency of VIP activation amounted to as much as 70% of that of fluoride at birth and to 35% only of fluoride activation in brain membranes from adult rats.     

Circulating Endothelial Progenitor Cells Decrease in Infants with Bronchopulmonary Dysplasia and Increase after Inhaled Nitric Oxide

Background

Impairment of endothelial progenitor cells (EPCs) has been shown to contribute to the development of bronchopulmonary dysplasia (BPD). In the current study, the relationship between EPC changes of after birth and the development of BPD was investigated, and the effects of inhaled nitric oxide (iNO) on EPCs were evaluated.

Methods

Sixty infants with a gestational age of less than 32 weeks and a birth weight of less than 1500 g were studied. NO was administered to infants who were receiving mechanical ventilation or CPAP for at least 2 days between the ages of 7 and 21 days. EPC level was determined by flow cytometry at birth, 7, 21 and 28 days of age and 36 weeks’ postmenstrual age (PMA), before and after the iNO treatment. Plasma concentrations of vascular endothelial growth factor (VEGF), stromal cell-derived factor-1 and granulocyte-macrophage colony-stimulating factor were determined via immunochemical assay.

Results

Twenty-five neonates developed BPD, 35 neonates survived and did not develop BPD. EPC level was decreased on day 7 and 21 in infants who later developed BPD compared with infants that did not develop BPD. From birth to 21 days of age, BPD infants had a persistently lower VEGF concentration compared with non-BPD infants. No difference was found between the two groups at day 28 or 36 weeks PMA. In infants that later developed BPD, iNO raised the KDR⁺CD133⁺ and CD34⁺KDR⁺CD133⁺ EPC numbers along with increasing the level of plasma VEGF.

Conclusion

EPC level was reduced at 7 days of age in infants with BPD, and iNO increased the EPC number along with increasing the level of VEGF. Further studies are needed to elucidate the mechanism leading to the decrease of EPCs in infants with BPD and to investigate the role of iNO treatment in the prevention of BPD.