Pathogenesis and treatment of bronchopulmonary dysplasia
- 1 June 2011
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Pediatrics
- Vol. 23 (3), 305-313
- https://doi.org/10.1097/mop.0b013e328346577f
Abstract
Purpose of review Bronchopulmonary dysplasia (BPD) is a chronic lung disease of infancy affecting mostly premature infants with significant morbidity and mortality. Improved survival of very immature infants has led to increased numbers of infants with this disorder. Acute and chronic lung injury and impaired postnatal lung growth are thought to be responsible for the development of BPD. Whereas changes in clinical practice have improved the clinical course and outcomes for infants with BPD, over the past decade, the overall incidence of BPD has not changed. This review will describe the prenatal and postnatal factors that contribute to the pathogenesis of BPD as well as current and experimental therapies for treatment of BPD. Recent findings The factors that contribute to the pathogenesis of BPD are well described; however, recent studies have better defined how these factors modulate lung growth. Inflammation, proinflammatory cytokines and altered angiogenic gene signaling contribute to lung injury and impair prenatal and postnatal lung growth resulting in BPD; however, to date no therapy has been identified that potently and consistently prevents or reverses their effects on lung growth. We will discuss the cell signaling pathways affected in BPD and current therapies available for modulating these pathways. Summary Despite current advances in neonatal care, BPD remains a heavy burden on healthcare resources. New treatments directed at either reducing lung injury or improving lung growth are under study.Keywords
This publication has 97 references indexed in Scilit:
- Early CPAP versus Surfactant in Extremely Preterm InfantsThe New England Journal of Medicine, 2010
- Bone marrow-derived angiogenic cells restore lung alveolar and vascular structure after neonatal hyperoxia in infant miceAmerican Journal of Physiology-Lung Cellular and Molecular Physiology, 2010
- Airway Delivery of Mesenchymal Stem Cells Prevents Arrested Alveolar Growth in Neonatal Lung Injury in RatsAmerican Journal of Respiratory and Critical Care Medicine, 2009
- Hyperoxia-induced neonatal rat lung injury involves activation of TGF-β and Wnt signaling and is protected by rosiglitazoneAmerican Journal of Physiology-Lung Cellular and Molecular Physiology, 2009
- Lung Recruitment for Ventilation: Does It Work, and is It Safe?The Journal of Pediatrics, 2009
- Blood cytokines and BPDThe Journal of Pediatrics, 2009
- Trends in severe bronchopulmonary dysplasia rates between 1994 and 2002The Journal of Pediatrics, 2005
- Increase in the concentration of transforming growth factor beta-1 in bronchoalveolar lavage fluid before development of chronic lung disease of prematurityThe Journal of Pediatrics, 1996
- Changing trends in the epidemiology and pathogenesis of neonatal chronic lung diseaseThe Journal of Pediatrics, 1995
- Bronchopulmonary dysplasia: Clinical presentationThe Journal of Pediatrics, 1979