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Milk protein and Oil‐Red‐O staining of alveolar macrophages in chronic respiratory disease of infancy
Author(s) -
De Baets Frans,
Aarts Claudia,
Van daele Sabine,
Haerynck Filomeen,
De Wachter Elke,
De Schutter Iris,
Malfroot Anne,
Schelstraete Petra
Publication year - 2010
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.21310
Subject(s) - medicine , tracheomalacia , staining , immunostaining , concomitant , pathology , gastroenterology , respiratory system , immunohistochemistry , surgery , airway
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 (α‐lactalbumin and β‐lactoglobulin) and compared these findings with the Oil‐Red‐O staining score. Broncho‐alveolar lavage (BAL), 24‐hr esophageal pH‐measurement and/or gastro‐esophageal 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 gastro‐esophageal 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. © 2010 Wiley‐Liss, Inc.