Bronchopulmonary dysplasia: Pathophysiology and potential anti-inflammatory therapies

Papagianis, Paris; Pillow, J. Jane; Moss, Timothy

doi:10.1016/j.prrv.2018.07.007

Cited by 41 publications

(33 citation statements)

References 132 publications

(150 reference statements)

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“…The effect of corticosteroids on hastening weaning from mechanical ventilation had been reported in preterms with BPD in neonatal intensive care units, but not in older infants with BPD aged more than 3 months 11 . The improvements observed after the start of high‐dose IV methylprednisolone in these two infants aged 6 and 7 months advocates for a persisting lung inflammation linked to their severe BPD and acutely exacerbated by mechanical ventilation, that was counteracted by this anti‐inflammatory treatment 17 . Two of the three infants who required chronic NIV in our study also seemed to improve after the IV pulses of methylprednisolone.…”

Section: Discussionmentioning

confidence: 92%

Intravenous pulses of methylprednisolone for infants with severe bronchopulmonary dysplasia and respiratory support after 3 months of age

Billion

Hadchouel

Garcelon

et al. 2020

Pediatric Pulmonology

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Introduction There are few published data on the efficacy of systemic corticosteroids in preterm infants with very severe forms of bronchopulmonary dysplasia (BPD), requiring respiratory support after 3 months of age. The aim of this study was to report the use of pulses of methylprednisolone in this population and its consequences on the level of respiratory support. Methods This retrospective monocentre study included infants over 3 months of age with severe BPD who received at least one pulse of methylprednisolone (300 mg/m2/day intravenous [IV] over 3 days). The primary outcome was the evolution of the pulmonary severity score (PSS) during the 3 months preceding and the 5 months following the first pulse. The evolution of the median PSS over time was analyzed using linear segmented regression for interrupted time series. Results Ten infants were included. During the 3 months preceding the first pulse, a significant increase in the median PSS was observed (p = .01), followed by a progressive decrease during the 5 months after administration of the first pulse (p < .01). Greater effects were observed in more severe infants requiring mechanical or noninvasive ventilation than in those receiving supplemental oxygen through nasal cannula. Conclusion High‐dose IV pulses of methylprednisolone were associated with a decrease in the level of respiratory support required by infants with very severe forms of BPD, with a greater effect in those on mechanical or noninvasive ventilation. Further studies are warranted to confirm these preliminary results and assess the long‐term safety of this therapy.

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Section: Discussionmentioning

confidence: 92%

Intravenous pulses of methylprednisolone for infants with severe bronchopulmonary dysplasia and respiratory support after 3 months of age

Billion

Hadchouel

Garcelon

et al. 2020

Pediatric Pulmonology

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“…Another investigation of 192 newborns found that lung infections in early newborns (particularly in the first 3 days of life) were related to the evolution of chronic lung disease (46). Under a combined effect of other BPD risk factors such as hyperoxia and mechanical ventilation, infection triggers a series of pro-inflammatory substances, such as IL-1β, IL-6, IL-8, NLRP3, TNF-α, and collagen I, which are further regulated by infiltrating neutrophils and macrophages (47)(48)(49). These inflammatory mediators in immature lungs of premature infants restrict the activity of surfactant proteins and the vascular endothelial growth factor (49), contributing to the development of alveolar and vascular alterations and other characteristic pathologies in BPD.…”

Section: Infection/inflammationmentioning

confidence: 99%

“…These inflammatory mediators in immature lungs of premature infants restrict the activity of surfactant proteins and the vascular endothelial growth factor (49), contributing to the development of alveolar and vascular alterations and other characteristic pathologies in BPD. Furthermore, TLR binding-induced reactive oxygen species (ROS) activate the NLRP3/caspase-1 pathway, which promotes IL-1b production (47), amplifying the inflammation process.…”

Section: Infection/inflammationmentioning

confidence: 99%

Perspectives on Probiotics and Bronchopulmonary Dysplasia

Yang

Dong

2020

Front. Pediatr.

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Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease of preterm infants, associated with high morbidity and hospitalization expenses. With the revolutionary advances in microbiological analysis technology, increasing evidence indicates that children with BPD are affected by lung microbiota dysbiosis, which may be related to the illness occurrence and progression. However, dysbiosis treatment in BPD patients has not been fully investigated. Probiotics are living microorganisms known to improve human health for their anti-inflammatory and anti-tumor effects, and particularly by balancing gut microbiota composition, which promotes gut-lung axis recovery. The aim of the present review is to examine current evidence of lung microbiota dysbiosis and explore potential applications of probiotics in BPD, which may provide new insights into treatment strategies of this disease.

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“…An additional complication of preterm birth is abnormal lung development. Bronchopulmonary dysplasia (BPD) is a chronic lung disease characterized by inflammation and arrest of alveolar development that affects 30-60% of infants born preterm [125][126][127][128]. Studies suggest that part of the oxidative and mechanical damage is the result of respiratory ventilation [129].…”

Section: Alterations In the Immune System And Epithelial Barrier Of Tmentioning

confidence: 99%

The Importance of Vaccinating Children and Pregnant Women against Influenza Virus Infection

Misra

Nayak

2019

Pathogens

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Influenza virus infection is responsible for significant morbidity and mortality in the pediatric and pregnant women populations, with deaths frequently caused by severe influenza-associated lower respiratory tract infection and acute respiratory distress syndrome (ARDS). An appropriate immune response requires controlling the viral infection through activation of antiviral defenses, which involves cells of the lung and immune system. High levels of viral infection or high levels of inflammation in the lower airways can contribute to ARDS. Pregnant women and young children, especially those born prematurely, may develop serious complications if infected with influenza virus. Vaccination against influenza will lead to lower infection rates and fewer complications, even if the vaccine is poorly matched to circulating viral strains, with maternal vaccination offering infants protection via antibody transmission through the placenta and breast milk. Despite the health benefits of the influenza vaccine, vaccination rates around the world remain well below targets. Trust in the use of vaccines among the public must be restored in order to increase vaccination rates and decrease the public health burden of influenza.

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Bronchopulmonary dysplasia: Pathophysiology and potential anti-inflammatory therapies

Cited by 41 publications

References 132 publications

Intravenous pulses of methylprednisolone for infants with severe bronchopulmonary dysplasia and respiratory support after 3 months of age

Intravenous pulses of methylprednisolone for infants with severe bronchopulmonary dysplasia and respiratory support after 3 months of age

Perspectives on Probiotics and Bronchopulmonary Dysplasia

The Importance of Vaccinating Children and Pregnant Women against Influenza Virus Infection

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