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Dogan Y, Arslan O, Oztas B, Kurtali A, Daryal AS, Eser MD. Comparison of Afamin Values in Umbilical Cord Blood After Delivery in Pregnancies With and Without Gestational Diabetes Mellitus. Fetal Pediatr Pathol 2024; 43:83-93. [PMID: 38189115 DOI: 10.1080/15513815.2023.2300981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Afamin is a protein that increases in gestational diabetes but its concentration in neonates hasn't been investigated. Our objective is to compare cord blood afamin levels in neonates born to mothers with and without diabetes, and to explore its relationship with maternal and neonatal variables. METHODS In this case control study, umbilical cord blood was collected for afamin measurement in pregestational/gestational diabetic pregnancies (n = 40) and healthy pregnancies (n = 45) after delivery. Correlation analysis was conducted to examine the relationship between afamin levels and maternal BMI, age, HbA1c, fasting and postprandial blood glucose, gestational age, birth weight. RESULTS The diabetic group had a higher median afamin level (p < 0.001). Afamin concentrations did not differ significantly between diabetic subgroups. The concentration of afamin in cord blood was independent of maternal BMI, age, HbA1c, blood glucose, gestational age, birth weight. CONCLUSION The concentration of afamin in cord blood of diabetic pregnancies is significantly higher, irrespective of other clinical factors.
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Affiliation(s)
- Yasemin Dogan
- Division of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | | | - Berrin Oztas
- Department of Medical Biochemistry, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Aylin Kurtali
- Department of Obstetrics and Gynecology, Burhaniye State Hospital, Balıkesir, Türkiye
| | - Ayse Seda Daryal
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
| | - Müzeyyen Dilsad Eser
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kocaeli University, Kocaeli, Türkiye
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2
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Ahmed S, Odumade OA, van Zalm P, Fatou B, Hansen R, Martin CR, Angelidou A, Steen H. Proteomics-Based Mapping of Bronchopulmonary Dysplasia-Associated Changes in Noninvasively Accessible Oral Secretions. J Pediatr 2023; 270:113774. [PMID: 37839510 PMCID: PMC11014893 DOI: 10.1016/j.jpeds.2023.113774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To determine if oral secretions (OS) can be used as a noninvasively collected body fluid, in lieu of tracheal aspirates (TA), to track respiratory status and predict bronchopulmonary dysplasia (BPD) development in infants born <32 weeks. STUDY DESIGN This was a retrospective, single center cohort study that included data and convenience samples from week-of-life (WoL) 3 from 2 independent preterm infant cohorts. Using previously banked samples, we applied our sample-sparing, high-throughput proteomics technology to compare OS and TA proteomes in infants born <32 weeks admitted to the Neonatal Intensive Care Unit (NICU) (Cohort 1; n = 23 infants). In a separate similar cohort, we mapped the BPD-associated changes in the OS proteome (Cohort 2; n = 17 infants including 8 with BPD). RESULTS In samples collected during the first month of life, we identified 607 proteins unique to OS, 327 proteins unique to TA, and 687 overlapping proteins belonging to pathways involved in immune effector processes, neutrophil degranulation, leukocyte mediated immunity, and metabolic processes. Furthermore, we identified 37 OS proteins that showed significantly differential abundance between BPD cases and controls: 13 were associated with metabolic and immune dysregulation, 10 of which (eg, SERPINC1, CSTA, BPI) have been linked to BPD or other prematurity-related lung disease based on blood or TA investigations, but not OS. CONCLUSIONS OS are a noninvasive, easily accessible alternative to TA and amenable to high-throughput proteomic analysis in preterm newborns. OS samples hold promise to yield actionable biomarkers of BPD development, particularly for prospective categorization and timely tailored treatment of at-risk infants with novel therapies.
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Affiliation(s)
- Saima Ahmed
- Department of Pathology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Oludare A Odumade
- Harvard Medical School, Boston, MA; Division of Neonatology, Boston Children's Hospital and Harvard Medical School, Boston, MA; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Patrick van Zalm
- Department of Pathology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Benoit Fatou
- Department of Pathology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Rachel Hansen
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Asimenia Angelidou
- Harvard Medical School, Boston, MA; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Hanno Steen
- Department of Pathology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA; Precision Vaccines Program, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
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3
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Dylag AM, Misra RS, Bandyopadhyay G, Poole C, Huyck HL, Jehrio MG, Haak J, Deutsch GH, Dvorak C, Olson HM, Paurus V, Katzman PJ, Woo J, Purkerson JM, Adkins JN, Mariani TJ, Clair GC, Pryhuber GS. New insights into the natural history of bronchopulmonary dysplasia from proteomics and multiplexed immunohistochemistry. Am J Physiol Lung Cell Mol Physiol 2023; 325:L419-L433. [PMID: 37489262 PMCID: PMC10642360 DOI: 10.1152/ajplung.00130.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023] Open
Abstract
Bronchopulmonary dysplasia (BPD) is a disease of prematurity related to the arrest of normal lung development. The objective of this study was to better understand how proteome modulation and cell-type shifts are noted in BPD pathology. Pediatric human donors aged 1-3 yr were classified based on history of prematurity and histopathology consistent with "healed" BPD (hBPD, n = 3) and "established" BPD (eBPD, n = 3) compared with respective full-term born (n = 6) age-matched term controls. Proteins were quantified by tandem mass spectroscopy with selected Western blot validations. Multiplexed immunofluorescence (MxIF) microscopy was performed on lung sections to enumerate cell types. Protein abundances and MxIF cell frequencies were compared among groups using ANOVA. Cell type and ontology enrichment were performed using an in-house tool and/or EnrichR. Proteomics detected 5,746 unique proteins, 186 upregulated and 534 downregulated, in eBPD versus control with fewer proteins differentially abundant in hBPD as compared with age-matched term controls. Cell-type enrichment suggested a loss of alveolar type I, alveolar type II, endothelial/capillary, and lymphatics, and an increase in smooth muscle and fibroblasts consistent with MxIF. Histochemistry and Western analysis also supported predictions of upregulated ferroptosis in eBPD versus control. Finally, several extracellular matrix components mapping to angiogenesis signaling pathways were altered in eBPD. Despite clear parsing by protein abundance, comparative MxIF analysis confirms phenotypic variability in BPD. This work provides the first demonstration of tandem mass spectrometry and multiplexed molecular analysis of human lung tissue for critical elucidation of BPD trajectory-defining factors into early childhood.NEW & NOTEWORTHY We provide new insights into the natural history of bronchopulmonary dysplasia in donor human lungs after the neonatal intensive care unit hospitalization. This study provides new insights into how the proteome and histopathology of BPD changes in early childhood, uncovering novel pathways for future study.
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Affiliation(s)
- Andrew M Dylag
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Ravi S Misra
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Gautam Bandyopadhyay
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Cory Poole
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Heidie L Huyck
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Matthew G Jehrio
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Jeannie Haak
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Gail H Deutsch
- Department of Laboratory Medicine and Pathology, University of Washington, University of Washington, Seattle, Washington, United States
| | - Carly Dvorak
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Heather M Olson
- Pacific Northwest National Laboratories, Richland, Washington, United States
| | - Vanessa Paurus
- Pacific Northwest National Laboratories, Richland, Washington, United States
| | - Philip J Katzman
- Department of Pathology, University of Rochester Medical Center, Rochester, New York, United States
| | - Jongmin Woo
- Pacific Northwest National Laboratories, Richland, Washington, United States
| | - Jeffrey M Purkerson
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Joshua N Adkins
- Pacific Northwest National Laboratories, Richland, Washington, United States
| | - Thomas J Mariani
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
| | - Geremy C Clair
- Pacific Northwest National Laboratories, Richland, Washington, United States
| | - Gloria S Pryhuber
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States
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4
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Bonadies L, Moschino L, Valerio E, Giordano G, Manzoni P, Baraldi E. Early Biomarkers of Bronchopulmonary Dysplasia: A Quick Look to the State of the Art. Am J Perinatol 2022; 39:S26-S30. [PMID: 36470296 DOI: 10.1055/s-0042-1758867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bronchopulmonary dysplasia (BPD) is one of the most common pulmonary sequelae of extreme preterm birth, with long-lasting respiratory symptoms and reduced lung function. A reliable predictive tool of BPD development is urgent and its search remains one of the major challenges for neonatologists approaching the upcoming arrival of possible new preventive therapies. Biomarkers, identifying an ongoing pathogenetic pathway, could allow both the selection of preterm infants with an evolving disease and potentially the therapeutic targets of the indicted pathogenesis. The "omic" sciences represent well-known promising tools for this objective. In this review, we resume the current laboratoristic, metabolomic, proteomic, and microbiomic evidence in the prediction of BPD. KEY POINTS: · The early prediction of BPD development would allow the targeted implementation of new preventive therapies.. · BPD is a multifactorial disease consequently it is unlikely to find a single disease biomarker.. · "Omic" sciences offer a promising insight in BPD pathogenesis and its development's fingerprints..
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Affiliation(s)
- Luca Bonadies
- Neonatal Intensive Care Unit, Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy.,Department of Woman's and Child's Health, Institute of Pediatric Research "Città della Speranza," Padova, Italy
| | - Laura Moschino
- Neonatal Intensive Care Unit, Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy.,Department of Woman's and Child's Health, Institute of Pediatric Research "Città della Speranza," Padova, Italy
| | - Enrico Valerio
- Neonatal Intensive Care Unit, Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy.,Department of Woman's and Child's Health, Institute of Pediatric Research "Città della Speranza," Padova, Italy
| | - Giuseppe Giordano
- Department of Woman's and Child's Health, Institute of Pediatric Research "Città della Speranza," Padova, Italy.,Department of Woman's and Child's Health, Mass Spectrometry and Metabolomic Laboratory, University of Padova, Padova, Italy
| | - Paolo Manzoni
- Division of Pediatrics and Neonatology, Department of Maternal, Neonatal and Infant Medicine, University Hospital "Degli Infermi," Ponderano, Italy.,Department of Sciences of Public Health and Pediatrics, University of Turin School of Medicine, Turin, Italy
| | - Eugenio Baraldi
- Neonatal Intensive Care Unit, Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy.,Department of Woman's and Child's Health, Institute of Pediatric Research "Città della Speranza," Padova, Italy.,Department of Woman's and Child's Health, Mass Spectrometry and Metabolomic Laboratory, University of Padova, Padova, Italy
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5
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Kimble A, Robbins ME, Perez M. Pathogenesis of Bronchopulmonary Dysplasia: Role of Oxidative Stress from 'Omics' Studies. Antioxidants (Basel) 2022; 11. [PMID: 36552588 DOI: 10.3390/antiox11122380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) remains the most common respiratory complication of prematurity as younger and smaller infants are surviving beyond the immediate neonatal period. The recognition that oxidative stress (OS) plays a key role in BPD pathogenesis has been widely accepted since at least the 1980s. In this article, we examine the interplay between OS and genetic regulation and review 'omics' data related to OS in BPD. Data from animal models (largely models of hyperoxic lung injury) and from human studies are presented. Epigenetic and transcriptomic analyses have demonstrated several genes related to OS to be differentially expressed in murine models that mimic BPD as well as in premature infants at risk of BPD development and infants with established lung disease. Alterations in the genetic regulation of antioxidant enzymes is a common theme in these studies. Data from metabolomics and proteomics have also demonstrated the potential involvement of OS-related pathways in BPD. A limitation of many studies includes the difficulty of obtaining timely and appropriate samples from human patients. Additional 'omics' studies could further our understanding of the role of OS in BPD pathogenesis, which may prove beneficial for prevention and timely diagnosis, and aid in the development of targeted therapies.
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Cheema Z, Kwinta P, Moreira A, Tovar M, Mustafa SB. Big Data for Tiny Patients: A Precision Medicine Approach to Bronchopulmonary Dysplasia. Pediatr Ann 2022; 51:e396-e404. [PMID: 36215088 DOI: 10.3928/19382359-20220803-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease of extreme prematurity. Despite more than 50 years of research, current treatments are ineffective, and clinicians are largely unable to accurately predict which neonates the condition will develop in. A deeper understanding of the molecular mechanisms underlying the characteristic arrest in lung development are warranted. Integrating high-fidelity technology from precision medicine approaches may fill this gap and provide the tools necessary to identify biomarkers and targetable pathways. In this review, we describe insights garnered from current studies using omics for BPD prediction and stratification. We conclude by describing novel programs that will integrate multi-omics in efforts to better understand and treat the pathogenesis of BPD. [Pediatr Ann. 2022;51(10):e396-e404.].
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7
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Letunica N, Cai T, Cheong JLY, Doyle LW, Monagle P, Ignjatovic V. The use of proteomics for blood biomarker research in premature infants: a scoping review. Clin Proteomics 2021; 18:13. [PMID: 33853516 PMCID: PMC8048323 DOI: 10.1186/s12014-021-09316-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/18/2021] [Indexed: 12/18/2022] Open
Abstract
Over the last decade, the use of proteomics in the setting of prematurity has increased and has enabled researchers to successfully identify biomarkers for an array of associated morbidities. The objective of this scoping review was to identify the existing literature, as well as any knowledge gaps related to proteomic biomarker discoveries in the setting of prematurity. A scoping review was conducted using PubMed, Embase and Medline databases following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The study selection process yielded a total of 700 records, of which 13 studies were included in this review. Most studies used a tandem Mass Spectrometry (MS/MS) proteomics approach to identify key biomarkers. The corresponding studies identified proteins associated with retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC), late onset sepsis (LOS) and gestational age. This scoping review demonstrates the limited use of proteomics to identify biomarkers associated with severe complications of prematurity. Further research is warranted to identify biomarkers of other important morbidities associated with prematurity, such as intraventricular haemorrhage (IVH) and cerebral palsy, and to investigate the mechanisms associated with these outcomes.
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Affiliation(s)
- Natasha Letunica
- Haematology Research Laboratory, Murdoch Children's Research Institute, Parkville, Australia
| | - Tengyi Cai
- Haematology Research Laboratory, Murdoch Children's Research Institute, Parkville, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Parkville, Australia.,Department of Obstetrics and Gynecology, The Royal Women's Hospital, Parkville, Australia.,Newborn Research, The Royal Women's Hospital, Parkville, Australia
| | - Lex W Doyle
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Australia.,Department of Obstetrics and Gynecology, The Royal Women's Hospital, Parkville, Australia.,Newborn Research, The Royal Women's Hospital, Parkville, Australia
| | - Paul Monagle
- Haematology Research Laboratory, Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Australia.,Department of Clinical Haematology, Royal Children's Hospital, Parkville, Australia
| | - Vera Ignjatovic
- Haematology Research Laboratory, Murdoch Children's Research Institute, Parkville, Australia. .,Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Australia.
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Faust K, Freitag N, Barrientos G, Hartel C, Blois SM. Galectin-Levels Are Elevated in Infants Born Preterm Due to Amniotic Infection and Rapidly Decline in the Neonatal Period. Front Immunol 2021; 11:599104. [PMID: 33717050 PMCID: PMC7949913 DOI: 10.3389/fimmu.2020.599104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Abstract
Galectin (gal)-1, -3, and -9 are members of a family of glycan binding proteins that mediate complex interactions between decidual, inflammatory and trophoblast cells modulating several processes during gestation, control of the maternal immune system, and parturition. Their immunomodulatory role in preterm birth and postnatal expression in preterm infants is unknown. We performed a single center prospective study of 170 preterm infants with a gestational age below 35 weeks. Peripheral venous blood samples were collected during the neonatal period and galectin-1, -3, and -9 were determined by ELISA. We noted a strong decline of circulating gal-1 and -3 levels but not gal-9 from birth to day 7 of life. There was an inverse correlation of gal-1 and -3 levels at birth with gestational age. Gal-1 levels were remarkably increased in infants born to amniotic infection syndrome (AIS), which was also observed for gal-9 levels. Infants who developed early-onset sepsis had higher levels of gal-3 at day 1 as compared to unaffected infants. Our observational data imply that galectin-1, -3, and -9 levels are elevated in preterm infants born in an inflammatory milieu such as AIS or EOS. Future studies need to address whether galectins mediate inflammation-induced preterm birth and could therefore be a target for clinical trials.
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Affiliation(s)
- Kirstin Faust
- Department of Pediatrics, University of Luebeck, University Hospital of Schleswig-Holstein, Lübeck, Germany.,German Center for Infection Research, Lübeck, Germany
| | - Nancy Freitag
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Charité-Universitätsmedizin Berlin, Division of General Internal and Psychosomatic Medicine, Berlin, Germany
| | - Gabriela Barrientos
- Laboratorio de Medicina Experimental, Hospital Alemán-Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Christoph Hartel
- German Center for Infection Research, Lübeck, Germany.,Department of Paediatrics, University of Würzburg, Würzburg, Germany
| | - Sandra M Blois
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Charité-Universitätsmedizin Berlin, Berlin, Germany
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9
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Verder H, Heiring C, Ramanathan R, Scoutaris N, Verder P, Jessen TE, Höskuldsson A, Bender L, Dahl M, Eschen C, Fenger‐Grøn J, Reinholdt J, Smedegaard H, Schousboe P. Bronchopulmonary dysplasia predicted at birth by artificial intelligence. Acta Paediatr 2021; 110:503-509. [PMID: 32569404 PMCID: PMC7891330 DOI: 10.1111/apa.15438] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/14/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022]
Abstract
Aim To develop a fast bedside test for prediction and early targeted intervention of bronchopulmonary dysplasia (BPD) to improve the outcome. Methods In a multicentre study of preterm infants with gestational age 24‐31 weeks, clinical data present at birth were combined with spectral data of gastric aspirate samples taken at birth and analysed using artificial intelligence. The study was designed to develop an algorithm to predict development of BPD. The BPD definition used was the consensus definition of the US National Institutes of Health: Requirement of supplemental oxygen for at least 28 days with subsequent assessment at 36 weeks postmenstrual age. Results Twenty‐six (43%) of the 61 included infants developed BPD. Spectral data analysis of the gastric aspirates identified the most important wave numbers for classification and surfactant treatment, and birth weight and gestational age were the most important predictive clinical data. By combining these data, the resulting algorithm for early diagnosis of BPD had a sensitivity of 88% and a specificity of 91%. Conclusion A point‐of‐care test to predict subsequent development of BPD at birth has been developed using a new software algorithm allowing early targeted intervention of BPD which could improve the outcome.
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Affiliation(s)
- Henrik Verder
- Department of Pediatrics Holbaek University Hospital Holbaek Denmark
| | - Christian Heiring
- Department of Neonatology, Rigshospitalet University of Copenhagen Copenhagen Denmark
| | - Rangasamy Ramanathan
- Department of Pediatrics Division of Neonatology LAC+USC Medical Center & PH Good Samaritan Hospital Los Angeles CA USA
| | | | - Povl Verder
- Department of Pediatrics Holbaek University Hospital Holbaek Denmark
| | - Torben E. Jessen
- Department of Pediatrics Holbaek University Hospital Holbaek Denmark
| | - Agnar Höskuldsson
- Department of Pediatrics Holbaek University Hospital Holbaek Denmark
| | - Lars Bender
- Department of Paediatrics Aalborg Hospital University of Aalborg Aalborg Denmark
| | - Marianne Dahl
- Department of Paediatrics Odense Hospital University of Southern Denmark Odense Denmark
| | - Christian Eschen
- Department of Pediatrics Holbaek University Hospital Holbaek Denmark
| | - Jesper Fenger‐Grøn
- Department of Paediatrics Kolding Hospital University of Southern Denmark Kolding Denmark
| | - Jes Reinholdt
- Department of Paediatrics Herlev Hospital University of Copenhagen Copenhagen Denmark
| | - Heidi Smedegaard
- Department of Paediatrics Hvidovre Hospital University of Copenhagen Copenhagen Denmark
| | - Peter Schousboe
- Department of Pediatrics Holbaek University Hospital Holbaek Denmark
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10
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Abstract
In the current era, the survival of extremely low-birth-weight infants has increased considerably because of new advances in technology; however, these infants often develop chronic dysfunction of the lung, which is called bronchopulmonary dysplasia (BPD). BPD remains an important cause of neonatal mortality and morbidity despite newer and gentler modes of ventilation. BPD results from the exposure of immature lungs to various antenatal and postnatal factors that lead to an impairment in lung development and aberrant growth of lung parenchyma and vasculature. However, we still struggle with a uniform definition for BPD that can help predict various short- and long-term pulmonary outcomes. With new research, our understanding of the pathobiology of this disease has evolved, and many new mechanisms of lung injury and repair are now known. By utilizing the novel ‘omic’ approaches in BPD, we have now identified various factors in the disease process that may act as novel therapeutic targets in the future. New investigational agents being explored for the management and prevention of BPD include mesenchymal stem cell therapy and insulin-like growth factor 1. Despite this, many questions remain unanswered and require further research to improve the outcomes of premature infants with BPD.
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Affiliation(s)
- Mitali Sahni
- Pediatrix Medical Group, Sunrise Children's Hospital, Las Vegas, NV, USA.,University of Nevada, Las Vegas, NV, USA
| | - Vineet Bhandari
- Neonatology Research Laboratory, Education and Research Building, Cooper University Hospital, Camden, NJ, USA
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