Caffeine, inflammation, and BPD

Abstract

In this issue of The Journal, Chavez Valdez et al provide observations on the relationship between serum caffeine levels and cytokine concentrations in tracheal aspirates and peripheral blood. The rationale for the study was to examine the role of caffeine, a non-selective adenosine receptor antagonist, in the regulation of pro- and anti-inflammatory cytokines. The results show that serum caffeine levels were higher after more than a week of treatment than they were after the initial doses. The relationship between caffeine levels and pro-inflammatory cytokines was U-shaped, meaning that at low serum caffeine levels TNF-α, IL-1 and IL-6 were reduced in concentration but at higher caffeine levels their levels were increased. One of the touted advantages of caffeine for the treatment of apnea of prematurity was the purported absence of the “need” to monitor levels. This study suggests that there is a complex relationship between caffeine levels and pro-inflammatory cytokines, which may contribute to the severity of inflammatory conditions, such as bronchopulmonary dysplasia (BPD), in children with high caffeine levels. This has important management and therapeutic implications. We may need to monitor caffeine levels if, indeed, these studies can be corroborated and a relationship between plasma caffeine levels, evoked inflammation, and BPD is further established.Article page 38 ▸ In this issue of The Journal, Chavez Valdez et al provide observations on the relationship between serum caffeine levels and cytokine concentrations in tracheal aspirates and peripheral blood. The rationale for the study was to examine the role of caffeine, a non-selective adenosine receptor antagonist, in the regulation of pro- and anti-inflammatory cytokines. The results show that serum caffeine levels were higher after more than a week of treatment than they were after the initial doses. The relationship between caffeine levels and pro-inflammatory cytokines was U-shaped, meaning that at low serum caffeine levels TNF-α, IL-1 and IL-6 were reduced in concentration but at higher caffeine levels their levels were increased. One of the touted advantages of caffeine for the treatment of apnea of prematurity was the purported absence of the “need” to monitor levels. This study suggests that there is a complex relationship between caffeine levels and pro-inflammatory cytokines, which may contribute to the severity of inflammatory conditions, such as bronchopulmonary dysplasia (BPD), in children with high caffeine levels. This has important management and therapeutic implications. We may need to monitor caffeine levels if, indeed, these studies can be corroborated and a relationship between plasma caffeine levels, evoked inflammation, and BPD is further established. Article page 38 ▸ Correlation between Serum Caffeine Levels and Changes in Cytokine Profile in a Cohort of Preterm InfantsThe Journal of PediatricsVol. 158Issue 1PreviewTo determine changes in cytokine levels associated with caffeine treatment in a cohort of preterm infants. Full-Text PDF