Modulators of inflammation in Bronchopulmonary Dysplasia

Savani, Rashmin C.

doi:10.1053/j.semperi.2018.09.009

Cited by 84 publications

(68 citation statements)

References 178 publications

(173 reference statements)

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“…Aerosol delivery of medications to preterm infants, while they are managed with NIV, has been attempted for decades with limited success [11,27]. Eventually, an efficient method of non-invasive aerosol delivery should enable the safe prevention and treatment of lung conditions associated to preterm birth, such as RDS and BPD, by the topical administration of nebulized surfactant, anti-inflammatory drugs, and other molecules that promote lung development [27,28]. Unfortunately, lung deposition in preterm infants is very low, and is fundamentally affected by the low lung volumes and fast breathing rates of preterm babies, the nebulizer type, the diluting effect of the bias flow during NIV and the NIV ventilation circuit, including the NIV interface [11,29].…”

Section: Discussionmentioning

confidence: 99%

Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs

et al. 2020

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The delivery of nebulized medications to preterm infants during Non-Invasive Ventilation (NIV) remains an unmet clinical need. In this regard, the effective delivery of nebulized surfactant has been particularly investigated in preclinical and clinical studies. In this work, we investigated the feasibility of delivering nebulized surfactant through various commercially available nasal prong types. We first performed a compendial characterization of surfactant aerosols generated by the eFlow Neos nebulizer, customized to be used in neonates, determining the amount of surfactant delivered by the device as well as the aerodynamic characteristics of surfactant aerosols. Additionally, we extended the compendial characterization by testing the effect of different nasal prong types on the estimated lung dose using a realistic Continuous Positive Airway Pressure (CPAP) circuit that included a cast of the upper airways of a preterm neonate. The compendial characterization of surfactant aerosols delivered through different nasal prongs achieved relatively high delivered surfactant doses (in the range 63–74% of the nominal dose), with aerodynamic characteristics displaying mass median aerodynamic diameters ranging between 2.52 and 2.81 µm. Nevertheless, when using a representative in vitro setup mimicking NIV in a clinical setting, significant differences were observed in terms of the estimated lung dose accounting for up to two-fold differences (from 10% to 20% estimated lung deposition of the nominal dose) depending on the chosen nasal prong type. Considering that surfactant lung deposition rates are correlated with therapeutic efficacy, this study points out the relevance of choosing the appropriate NIV interface to maximize the lung dose of nebulized medications.

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Section: Discussionmentioning

confidence: 99%

Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs

et al. 2020

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“…The study selection process and exclusion criteria are described in Fig 1. Of the 128 studies identified initially, 120 were excluded based on review of the title, abstract or full text. The reasons for excluding 17 studies [33,34,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] after full-text review, are provided in Fig 1. The remaining eight studies met the inclusion criteria and were included in the meta-analysis [35,37,38,40,41,43,61,62].…”

Section: Literature Search and Study Selectionmentioning

confidence: 99%

Association between vitamin D level and bronchopulmonary dysplasia: A systematic review and meta-analysis

et al. 2020

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Neonatal vitamin D deficiency is common and is associated with development of pulmonary disease in children and adults. While the role of vitamin D in normal lung development is well established, the association between vitamin D deficiency and bronchopulmonary dysplasia (BPD) remains unclear. The present meta-analysis was conducted to evaluate the relationship between vitamin D and BPD. We identified relevant studies (n = 8) using the PubMed, EMBASE, Cochrane Library, and KoreaMed databases and applied the Newcastle-Ottawa Scale to assess the methodological components of each study, and used I 2 statistic to evaluate heterogeneity. Comprehensive Meta-Analysis software version 3.3 was used for the statistical analysis. A total of 909 infants were included, of whom 251 (27.6%) were diagnosed with BPD. We found that both vitamin D deficiency at birth (four studies; OR 2.405; 95% CI 1.269 to 4.560; p = 0.007) and low levels of vitamin D at birth (four studies; standardized mean difference-1.463; 95% CI-2.900 to-0.027; p = 0.046) were associated with BPD. The compiled data suggest that antenatal vitamin D deficiency and low vitamin D levels are associated with neonatal BPD.

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“…In ammation is the common pathway that leads to the phenotype of the disease and further compromises the structure and function of the patient's respiratory system (24). However, pro-in ammatory cascades are complex and redundant, involving numerous different cell types and molecular pathways triggered by either cell-to-cell interactions or paracrine signals from damaged tissues (34). Therefore, MSC transplantation emerges as a promising therapy investigated in a recently reported phase I clinical trial (21).…”

Section: Discussionmentioning

confidence: 99%

The First Allogeneic Transplantation of Human Umbilical Cord-derived Mesenchymal Stem/stromal Cells for Bronchopulmonary Dysplasia: Preliminary Outcomes in Four Vietnamese Infants

Thanh

Hong

et al. 2020

Preprint

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Abstract Background: Bronchopulmonary dysplasia (BPD) is a severe condition in premature infants that compromises theirlung function and necessitatesoxygen support. Despite major improvements in perinatal care minimizing the devastating effects, BPD remains the most frequent complication of extreme preterm birth. Our study reports the safety ofthe allogeneic administration of umbilical cord-derived mesenchymal stem/stromal cells (allo-UC-MSCs) and the preliminary efficacy of the treatment in four infants with established BPD.Methods: UC tissue was collected from a healthy donor, followed by propagation at the Stem Cell Core Facility at Vinmec Research Institute of Stem Cell and Gene Technology. UC-MSC culture was conducted under xeno-free and serum-free conditions. Four patients with established BPD were enrolled in this study between May 25, 2018, and December 31, 2018. All four patients received two intravenous doses of allo-UC-MSCs (1 million cells/kg patient body weight (PBW) per dose) with an intervening interval of 7 days. Safety and efficacy were evaluated during hospitalization and at 7 days and 1, 6 and 12 postdischargemonths.Results: No transplantation-associated severe adverse events or prespecified adverse events were observed in the four patients throughout the study period. At the time of this report, all patients had recovered from BPD and been weaned off of oxygen support. Chest X-rays and CT scans confirmed the dramatic reduction infibrosis.Conclusions: Allo-UC-MSC transplantation is safe and might improve respiratory function anddecrease lung fibrosis in preterm infants with established BPD.Trial registration: This preliminary study was approved by Vinmec International Hospital Ethics Board, approval number: 88/2019/QĐ-VMEC, registered 12 March 2019 - retrospectively registered.

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Modulators of inflammation in Bronchopulmonary Dysplasia

Cited by 84 publications

References 178 publications

Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs

Extended Pharmacopeial Characterization of Surfactant Aerosols Generated by a Customized eFlow Neos Nebulizer Delivered through Neonatal Nasal Prongs

Association between vitamin D level and bronchopulmonary dysplasia: A systematic review and meta-analysis

The First Allogeneic Transplantation of Human Umbilical Cord-derived Mesenchymal Stem/stromal Cells for Bronchopulmonary Dysplasia: Preliminary Outcomes in Four Vietnamese Infants

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