Evidence map›Paper›PMID 42204366›Full record

ArticlePediatric research2026

High rate of pulmonary exacerbations and neutrophilic airway inflammation in children with repaired esophageal atresia with or without tracheoesophageal fistula.

Illya Martynov, Amitai Hecht Nofar, Richard Wagner, Jan-Hendrik Gosemann, Steffi Mayer, Robin Wachowiak, Manuela Siekmeyer, Tobias Piegeler, Maximilian von Laffert, Tobias Lipek and 4 more

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Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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14 authors.

Illya MartynovDepartment of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany. illya.martynov@uni-marburg.de.
Amitai Hecht NofarDepartment of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany.
Richard WagnerDepartment of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
Jan-Hendrik GosemannDepartment of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
Steffi MayerDepartment of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
Robin WachowiakDepartment of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
Manuela SiekmeyerDepartment of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany.
Tobias PiegelerDepartment of Anesthesiology and Intensive Care, University of Leipzig Medical Center, Leipzig, Germany.
Maximilian von LaffertInstitute for Pathology, University of Leipzig Medical Center, Leipzig, Germany.
Tobias LipekDepartment of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany.
Norman LippmannInstitute of Medical Microbiology and Virology, University of Leipzig Medical Center, Leipzig, Germany.
Martin Lacher *Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany.
Freerk Prenzel *Department of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany.
Esophageal and Airway Treatment (EAT) Center Leipzig

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren with repaired esophageal atresia with or without tracheoesophageal fistula (EA/TEF) frequently have chronic respiratory morbidity, but airway inflammation is poorly defined. We described bronchoalveolar lavage (BAL) cell patterns in symptomatic EA/TEF and compared them with primary ciliary dyskinesia (PCD), protracted bacterial bronchitis (PBB), and healthy controls (HC).

methodsBAL profiles from symptomatic EA/TEF patients (n = 44) were analyzed against PCD (n = 10), PBB (n = 21), and HC (n = 16). Endoscopic bronchitis severity was assessed using the BScore. Associations between BScore and BAL profiles were assessed using multivariable modeling.

resultsAll EA/TEF patients had pulmonary exacerbations. BAL neutrophils were higher in EA TEF than HC (median 8.0%, IQR 3-25 vs 1.0%, IQR 0-2, p < 0.001) and similarly elevated in PBB and PCD. BScore correlated with neutrophils (Spearman rho 0.69, p < 0.001) and independently predicted neutrophilic inflammation (beta 4.53, 95% CI 1.78-7.28, p = 0.002). Pathogenic bacteria were cultured in 61%, most commonly Haemophilus influenzae (29.5%) and Staphylococcus aureus (25.0%).

conclusionsThis is the first study to systematically demonstrate neutrophil-driven airway inflammation in symptomatic children with repaired EA/TEF. These findings underscore the need for structured pulmonary follow up and the evaluation of anti inflammatory strategies in EA/TEF patients. IMPACT: Children with repaired EA/TEF and respiratory symptoms show frequent pulmonary exacerbations and neutrophil driven BAL inflammation. Neutrophil levels resemble protracted bacterial bronchitis and primary ciliary dyskinesia and track bronchoscopic bronchitis severity. Bronchoscopic bronchitis severity tracks neutrophilic inflammation and independently predicts it. Bacterial pathogens are common in BAL of EA/TEF children, supporting infection related airway injury risk. Results inform phenotype driven care pathways to reduce exacerbations and long term airway damage in EA/TEF children.

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PMID42204366

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