Late Pulmonary Sequelae of Bronchopulmonary Dysplasia

Northway, William H.; Moss, Richard B.; Carlisle, Kathryn B.; Parker, Bruce R.; Popp, Richard L.; Pitlick, Paul T.; Eichler, Irmgard; Lamm, Robert L.; Brown, Byron W.

doi:10.1056/nejm199012273232603

Cited by 522 publications

(335 citation statements)

References 30 publications

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“…38,39 Infants who develop bronchopulmonary dysplasia and survive later have chronic lung damage characterized by more frequent respiratory tract infections, episodes of wheezing, reduced airway function and airway obstruction. 40 Thus, exposure of fetal sheep to adenovirus gene transfer vectors early in development may stimulate untoward inflammatory and immune responses that could have long-term consequences.…”

Section: Figure 2 Effect Of Intratracheal Instillation Of Av1nbg On Lmentioning

confidence: 99%

Pulmonary inflammation associated with repeated, prenatal exposure to an E1, E3-deleted adenoviral vector in sheep

et al. 1999

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Fetal gene therapy may prove useful in treating diseases electively killed and 13 died in utero. The incidence of morthat manifest in the perinatal or early postnatal period.tality was higher than the р10% we have experienced with Adenoviruses effectively transfer gene expression to a varother fetal sheep studies and was not likely related to comiety of tissues but also stimulate inflammatory and immune plications arising from surgical or anesthetic procedures. responses. The purpose of this study was to test the Inflammatory and fibrotic responses were observed in the hypothesis that exposure of fetal sheep to a first generation lungs and may represent untoward long-term conseadenovirus vector encoding bacterial ␤-galactosidase, quences of in utero adenoviral gene therapy. Tolerance to Av1nBg, before the development of the immune system, is Av1nBg was not established, and repeated exposure to safe, minimizes inflammatory and immune responses and Av1nBg before birth was associated with significant patholinduces tolerance. A total of 22 fetal sheep was studied; of ogy and mortality. these, two were born with respiratory distress, seven were

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Section: Figure 2 Effect Of Intratracheal Instillation Of Av1nbg On Lmentioning

confidence: 99%

Pulmonary inflammation associated with repeated, prenatal exposure to an E1, E3-deleted adenoviral vector in sheep

et al. 1999

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“…The long-term outcomes of these patients were persistent pulmonary dysfunction. 2 The progress of neonatal care and the introduction of antenatal steroid therapy lowered the threshold for survival. The gestational age is markedly lower, and the histological changes are unique.…”

Section: Introductionmentioning

confidence: 99%

Antenatal inflammation and lung injury: prenatal origin of neonatal disease

Kramer¹

2008

J Perinatol

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“…24 The increased Rint in children with CLD in this study supports the finding of other studies that assessed airways resistance in other ways. 4,25 However, a similar study using the MicroRint device did not show a difference in respiratory resistance between their CLD and preterm control groups. 26 The possible reasons for this observation are that unlike their study group, participants in our study belonged to a younger age group.…”

Section: Discussionmentioning

confidence: 88%

“…It is associated with bronchial obstruction and hyperresponsiveness that may persist until school age or adulthood. [3][4][5][6] Respiratory morbidity, recurrent cough and/ or wheeze and lung function abnormalities are also common in prematurely born preschool children. 7,8 It is important to assess the degree of airways obstruction in these children to evaluate disease severity, predict symptoms, enable appropriate therapeutic interventions and measure response to treatment.…”

Section: Introductionmentioning

confidence: 99%

Lung function measurement in prematurely born preschool children with and without chronic lung disease

et al. 2008

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Objective: Prematurely born infants often have recurrent wheeze and long-term respiratory morbidity at follow-up. Assessment of airways obstruction in preschool children is feasible using the interrupter resistance (Rint) but has rarely been examined in preterm children with and without chronic lung disease (CLD). The objective of this study was to determine lung function measured by the interrupter technique, its feasibility in the ambulatory setting and respiratory health in prematurely born preschool children with and without CLD.Study Design: Preterm children of 2 to 4 years with severe CLD (>30% oxygen at 36 weeks and discharged home receiving supplemental oxygen) (n ¼ 43, median gestational age 27 weeks and median birth weight 995 g) and without CLD (n ¼ 33, median gestational age 29 weeks and median birth weight 1366 g) attempting lung function test for the first time were enrolled. Respiratory symptoms score was calculated using a questionnaire. A single set of 10 consecutive Rint measurements was obtained using a portable device (MicroRint). Median of at least five occlusions with consistent shape of mouth pressure-time curves was taken to be a Rint measurement. To assess feasibility the children were categorized as 'satisfactory', 'failure' and 'rejected' depending on the outcome of the test. Outcome variables were respiratory symptoms score and Rint.Result: Satisfactory Rint measurement was obtained in 46 (61%) children, 9 (36%) 2-year olds, 17 (65%) 3-year olds and 20 (80%) 4-year olds. As compared with the preterm control children (n ¼ 18), CLD children (n ¼ 28) had significantly higher respiratory symptoms score (18.5 vs 6, P<0.01) and Rint expressed as absolute values (kPa l À1 ) and z-scores (1.33 vs 1.16 and 1.42 vs 1.0, P<0.01), respectively. Conclusion:Rint measurement is feasible in prematurely born children of preschool age in the ambulatory setup. Preschool children with severe CLD may be identified from preterm children without CLD by increased Rint that may be used as a screening tool and as an outcome measure for interventions.

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Late Pulmonary Sequelae of Bronchopulmonary Dysplasia

Abstract: Most adolescents and young adults who had bronchopulmonary dysplasia in infancy have some degree of pulmonary dysfunction, consisting of airway obstruction, airway hyperreactivity, and hyperinflation. The clinical consequences of this dysfunction are not known.

Cited by 522 publications

References 30 publications

Pulmonary inflammation associated with repeated, prenatal exposure to an E1, E3-deleted adenoviral vector in sheep

Pulmonary inflammation associated with repeated, prenatal exposure to an E1, E3-deleted adenoviral vector in sheep

Antenatal inflammation and lung injury: prenatal origin of neonatal disease

Lung function measurement in prematurely born preschool children with and without chronic lung disease

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