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Abstract Objectives To compare LISA with INSURE technique for surfactant administration in preterm with gestational age (GA) < 36 weeks with RDS in respect to the incidence of pneumothorax, bronchopulmonary dysplasia (BPD), need for mechanical ventilation (MV), regional cerebral oxygen saturation (rSO2), peri‑intraventricular hemorrhage (PIVH) and mortality. Methods A systematic search in PubMed, Embase, Lilacs, CINAHL, SciELO databases, Brazilian Registry of Randomized Clinical Trials (ReBEC), Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. RCTs evaluating the effects of the LISA technique versus INSURE in preterm infants with gestational age < 36 weeks and that had as outcomes evaluation of the rates of pneumothorax, BPD, need for MV, rSO2, PIVH, and mortality were included in the meta-analysis. Random effects and hazard ratio models were used to combine all study results. Inter-study heterogeneity was assessed using Cochrane Q statistics and Higgin's I2 statistics. Results Sixteen RCTs published between 2012 and 2020 met the inclusion criteria, a total of 1,944 preterms. Eleven studies showed a shorter duration of MV and CPAP in the LISA group than in INSURE group. Two studies evaluated rSO2 and suggested that LISA and INSURE transiently affect brain autoregulation during surfactant administration. INSURE group had a higher risk for MV in the first 72 h of life, pneumothorax, PIVH and mortality in comparison to the LISA group. Conclusion This systematic review and meta-analyses provided evidence for the benefits of the LISA technique in the treatment of RDS, decreasing CPAP time, need for MV, BPD, pneumothorax, PIVH, and mortality when compared to INSURE.
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OBJECTIVE To investigate the improvement effects of azithromycin on bronchopulmonary dysplasia （BPD） in neonatal rats based on hypoxia-inducible factor-1α（HIF-1α）/HIF-2α/vascular endothelial growth factor （VEGF） pathway. METHODS Sixty newborn SD rats were randomly divided into negative control group （NC）， BPD group， azithromycin group and budesonide group （positive control）， with 15 rats in each group. Rats in NC group were given normal breathing air， while rats in other three groups were exposed to high-concentration oxygen for 14 days to establish BPD rat models. After successful modeling， rats in azithromycin group were intraperitoneally injected with azithromycin 200 mg/kg， and rats in budesonide group were atomized with budesonide 1.5 mg/kg once a day for 14 consecutive days， while rats in BPD group and NC group were not treated. Pathological changes of lung tissue， radial alveolar count and mean alveolar intercept of rats were observed in each group. The white blood cell count in bronchoalveolar lavage fluid （BALF） and the levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， IL-1β， superoxide dismutase （SOD）， catalase （CAT） and malondialdehyde （MDA） were detected； mRNA and protein expressions of VEGF， HIF-1α， HIF-2α were also detected. RESULTS Compared with NC group， the lung tissue in BPD group was obviously damaged； the white blood cell count， average alveolar intercept and the levels of TNF-α， IL-6， IL-1β and MDA were significantly increased； the radial alveolar count， SOD and CAT levels， the relative expressions of VEGF， HIF-1α， HIF-2α mRNA and protein were significantly decreased （P＜0.05）. Compared with BPD group， the changes of the above indexes in azithromycin group and budesonide group were significantly reversed （P＜0.05）. CONCLUSIONS Azithromycin can obviously improve the symptoms of BPD in rats， reduce inflammation and oxidative stress， and exert lung protection， the mechanism of which may be realized by activating HIF-1α/HIF-2α/VEGF pathway.
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Abstract Objective: Among the mechanisms proposed for the development of bronchopulmonary dysplasia is the increase in the pulmonary inflammatory process and oxidative stress. Thus, the control of this process may result in improvements in bronchopulmonary dysplasia-related outcomes. This study aims to analyze the current scientific evidence regarding the use of budesonide, a potent anti-inflammatory drug, associated with a pulmonary surfactant to prevent bronchopulmonary dysplasia. Methods: A systematic review of the literature was performed on the Embase and MEDLINE platforms, and studies that compared budesonide with pulmonary surfactant versus pulmonary surfactant for treating respiratory distress syndrome were included. The primary outcome was a reduction in bronchopulmonary dysplasia or death. Results: Four randomized clinical trials and two observational studies were included in this systematic review. Three of the randomized clinical trials found a reduction in bronchopulmonary dysplasia or death in the use of budesonide with the surfactant, all the other studies (1 clinical trial and 2 observational studies) found no statistical differences between the groups for the primary outcomes. The three main studies showed a reduction in the primary outcome; however, all studies showed great heterogeneity regarding the type of surfactant (poractant or beractant) and the method of administration. Conclusion: Robust clinical studies, in a heterogeneous population, using porcine surfactant associated with budesonide, with administration by a minimally invasive technique are necessary for there to be a recommendation based on scientific evidence for its widespread use.
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SUMMARY OBJECTIVE: This study aimed to explore the risk factors of bronchopulmonary dysplasia in premature infants and the clinical application value of lung ultrasound in the diagnosis of bronchopulmonary dysplasia. METHODS: A total of 80 premature infants with a gestational age of <32 weeks or a birth weight of <1,500 g who were treated in our hospital from January to August 2021 were randomly divided into a bronchopulmonary dysplasia group (n=12) and a non-bronchopulmonary dysplasia group (n=62). The clinical data, lung ultrasound, and X-ray image characteristics of the two groups were compared. RESULTS: Among the 74 preterm infants, 12 preterm infants were diagnosed with bronchopulmonary dysplasia, and 62 preterm infants were determined not to have bronchopulmonary dysplasia. There were significant differences in sex, severe asphyxia, invasive mechanical ventilation, premature membrane ruptures, and intrauterine infection between the two groups (p<0.05). Lung ultrasound showed abnormal pleural lines and alveolar-interstitial syndrome in all 12 patients with bronchopulmonary dysplasia and vesicle inflatable signs in 3 patients. Before clinical diagnosis, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of lung ultrasound in the diagnosis of bronchopulmonary dysplasia were 98.65, 100, 98.39, 92.31, and 100%, respectively. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of X-rays in the diagnosis of bronchopulmonary dysplasia were 85.14, 75.00, 87.10, 52.94, and 94.74%, respectively. CONCLUSION: The diagnostic efficiency of lung ultrasound for premature bronchopulmonary dysplasia is better than that of X-rays. The application of lung ultrasound can screen patients with bronchopulmonary dysplasia early for timely intervention.
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Objective:To study the current status and existing problems of bronchopulmonary dysplasia (BPD) in preterm infants in Chinese literature using bibliometric methods.Methods:Using "preterm infants", "BPD" and "chronic lung disease of prematurity"(Chinese version)as keywords, Wanfang database was searched up to August 27th, 2022. Literature published in high-influencing journals were selected for bibliometrical and social network analysis.Results:A total of 2 172 articles published in 311 journals were included. The number of articles increased rapidly year by year, involving studies on the risk factors and respiratory management of BPD. Dynamic researches focused on the following topics:1,selection of multiple non-invasive ventilation modes combined with minimally invasive surfactant administration; 2,the application of caffeine and glucocorticoids and 3, follow-up after discharge.Conclusions:In the past 40 years, research on BPD in preterm infants in China has mainly focused on risk factors and prevention. However, research on pathogenesis and other aspects needs to be strengthened.
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Objective:To study the risk factors and prognosis of pulmonary hypertension(PH) associated with bronchopulmonary dysplasia (BPD) in extremely preterm infants(EPIs).Methods:From January 2020 to December 2021, EPIs [gestational age (GA) <32 w] with BPD admitted to NICU of our hospital were retrospectively assigned into two groups: BPD with late-onset PH(PH group) and BPD without late-onset PH(non-PH group). Their general condition, treatment and prognosis were compared and the risk factors of late-onset PH were analyzed.Results:A total of 229 EPIs with BPD were enrolled, including 24(10.5%) in the PH group and 205(89.5%) in the non-PH group. The PH group had significantly smaller GA [(27.9±2.3) w vs. (28.7±1.8) w], longer mechanical ventilation [42.0(16.0, 84.0) d vs. 9.0(2.0, 23.0) d], longer hospital stay [100.5(86.3, 142.0) d vs. 77.0(56.5, 96.5)d],higher incidence of early-onset PH(54.2% vs. 9.3%) and higher mortality rate(33.3% vs. 9.8%) than the non-PH group ( P<0.05). Multivariate logistic regression analysis showed prolonged mechanical ventilation ( OR=1.046, 95% CI 1.011~1.064), early-onset PH ( OR=5.414, 95% CI 1.796~16.323) were independent risk factors for BPD with late-onset PH. 8(33.3%) patients in the PH group died, including 2 with grade Ⅱ BPD and 6 grade Ⅲ BPD. Conclusions:Prolonged mechanical ventilation and early-onset PH are independent risk factors for late-onset PH in BPD infants. BPD infants with late-onset PH have longer hospital stay, higher mortality and worse prognosis.
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Objective:To study the effects of patent ductus arteriosus (PDA) on bronchopulmonary dysplasia (BPD) in very low birth weight preterm infants (VLBWIs).Methods:From January 2018 to December 2020,VLBWIs hospitalized in NICU of our hospital were retrospectively analyzed.They were assigned into BPD group and non-BPD group according to whether BPD occurred. Clinical data including the severity of BPD , the diameter and duration of PDA and ibuprofen usage were analyzed. The predictive values of PDA diameter and duration for BPD were calculated using area under curve (AUC) of receiver operating characteristic curve (ROC) analysis.Results:A total of 173 VLBWIs were enrolled, including 42 in the BPD group and 131 in the non-BPD group. The incidence of hemodynamically significant PDA (hsPDA) in the BPD group was significantly higher than the non-BPD group (45.2% vs. 22.1%, P=0.001).hsPDA ( OR=2.806, 95% CI 1.307-5.745, P=0.005), PDA diameter ≥1.5 mm ( OR=7.003, 95% CI 1.323-48.884, P<0.001) and PDA duration >1 w ( OR=7.754, 95% CI 1.203-49.989, P=0.031) were all risk factors for BPD.As for the severity of BPD, hsPDA, PDA diameter ≥1.5 mm, PDA duration >1 w and FiO 2max >30% within 72 h after birth were risk factors for grade Ⅱ~Ⅲ BPD. The incidence of ibuprofen usage was significantly higher in grade Ⅱ~Ⅲ BPD group. If the diameter of PDA was 1.25 mm, the AUC was 0.806 (95% CI 0.706-0.906, P<0.001), sensitivity 82.6% and specificity 68.7% for grade Ⅱ~Ⅲ BPD. If the PDA duration was 10.5 d, the AUC was 0.821 (95% CI 0.718-0.925, P<0.001), sensitivity 65.2% and specificity 91.3%. Conclusions:hsPDA, larger PDA diameter and longer PDA duration are risk factors for the occurrence and severity of BPD in VLBWIs.
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Objective:To study the risk factors and clinical outcomes of early pulmonary hypertension in preterm infants with gestational age(GA)≤32 w.Methods:From October 2017 to May 2021,preterm infants with GA≤ 32 w admitted to NICU of our hospital were retrospectively studied. According to their echocardiography 2 w after birth, the infants were assigned into early-onset pulmonary hypertension (ePH) group and non-PH group. SPSS 21.0 statistical software was used to analyze the general status, complications and clinical outcomes of the two groups. Multiple logistic regression was used to analyze the risk factors of early-onset PH.Results:A total of 183 cases were enrolled, including 24 in the ePH group and 159 in the non-PH group. The incidences of birth asphyxia, hemodynamically significant patent ductus arteriosus (hsPDA), FiO 2≥30% within 6 h after birth, late-onset PH, severe bronchopulmonary dysplasia(BPD) and intracranial hemorrhage(ICH) in the ePH group were significantly higher than the non-PH group( P<0.05). hsPDA was the independent risk factor for early-onset PH ( OR=11.781, 95% CI 4.192-33.108). Conclusions:Preterm infants with GA≤32 w and early-onset PH are at increased risks of ICH, late-onset PH and severe BPD, hsPDA is the independent risk factor for early-onset PH.
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Objective:To study the role of miRNA-15b and vascular endothelial growth factor (VEGF) in the pathogenesis of novel bronchopulmonary dysplasia (nBPD) in rats.Methods:A total of 100 newborn SD rats were randomly assigned into BPD group and control group with 50 rats in each group. The BPD group was placed in oxygen chamber with 60% oxygen concentration and the control group received atmospheric air. The morphological changes of lung tissues were observed on 1 d, 7 d, 14 d and 21 d and the radial alveolar counts (RAC) and alveolar septal thickness (AST) were measured. The expression of miR-15b was measured using real-time quantitative PCR and the expression of VEGF in lung tissue was examined using ELISA method.Results:With prolonged oxygen exposure, the lung tissue of the BPD group showed a decrease in the number of alveoli, a gradual loss of the normal structure of alveoli and a significant widening of the alveolar septum. On 7 d, 14 d and 21 d, RAC values [(6.19±0.29) vs. (6.86±0.92), (5.35±0.67) vs.(9.75±0.34), (3.96±0.45) vs. (10.04±0.52)] were significantly lower in the BPD group than the control group ( P<0.05). On 7 d, 14 d and 21 d,the levels of AST in BPD group were significantly higher than the control group [(6.87±0.41) μm vs. (6.43±0.31) μm, (8.94±0.25) μm vs. (5.36±0.26) μm, (9.61±0.30) μm vs. (4.55±0.32) μm] ( P<0.05). On 7 d, 14 d and 21 d,the miR-15b expression in BPD group were significantly higher than the control group [(1.12±0.11) vs. (0.84±0.09), (1.33±0.09) vs. (0.73±0.07), (1.66±0.15) vs. (0.45±0.10)] ( P<0.05).On 7 d, 14 d and 21 d, VEGF in BPD group were significantly lower than the control group [(10.89±1.67) pg/ml vs. (23.86±4.38) pg/ml, (8.75±1.28) pg/ml vs. (53.94±3.49) pg/ml, (4.66±1.12) pg/ml vs. (70.37±3.10) pg/ml] ( P<0.05). Conclusions:MiR-15b and VEGF may play a role in the development of nBPD.
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Objective:To evaluate the effects of quality improvement (QI) program on the incidence of bronchopulmonary dysplasia (BPD) in very preterm infants (VPIs) [gestational age (GA)<32 weeks].Methods:From July to December 2017,VPIs admitted to the Department of Neonatology of Yancheng Maternity and Child Health Care Hospital were retrospectively enrolled and were assigned into pre-quality improvement program group (Pre-QI group).From July to December 2018, VPIs were assigned into post-quality improvement program group (Post-QI group). QI program included delayed umbilical cord clamping (DCC), early postnatal nasal continuous positive airway pressure ventilation (nCPAP) and minimally invasive pulmonary surfactant therapy (MIST). The clinical data and prognostic indicators of the two groups of VPIs and their mothers were compared. Independent sample t-test or continuity-adjusted Chi-square test (or Fisher's exact test) and Logistic regression were used for statistical analysis. Results:A total of 204 VPIs were enrolled, including 96 cases in Pre-QI group and 108 cases in Post-QI group. 1 min Apgar score and hematocrit on admission to the neonatal intensive care unit (NICU) in the Post-QI group were significantly higher than the Pre-QI group( P<0.05). The incidence of delivery room resuscitation, endotracheal intubation at birth and endotracheal intubation in NICU in the Post-QI group were significantly lower than the Pre-QI group( P<0.05). The application of pulmonary surfactant and mechanical ventilation, the incidence of neonatal respiratory distress syndrome and BPD in the Post-QI group were lower than the Pre-QI group ( P<0.05). After adjusting for confounding factors, Logistic regression analysis showed that DCC ( aOR=0.261,95% CI 0.091~0.718, P=0.023), nCPAP ( aOR=0.284,95% CI 0.123~0.667, P=0.015), MIST ( aOR=0.276,95% CI 0.114~0.627, P=0.011) were protective factors of BPD, and MV ( aOR=2.023,95% CI 1.048~3.918, P=0.036) was risk factor of BPD. Conclusions:The QI program consisting of DCC, early nCPAP and MIST for VPIs can reduce the incidence of BPD.
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Objective:To study the early predictive values of serum thrombospondin-1(TSP-1)and transforming growth factor-β1(TGF-β1) for bronchopulmonary dysplasia(BPD)in preterm infants.Methods:From September 2020 to April 2022, preterm infants with gestational age<32 weeks and ≥28 weeks as well as birth weight<1 500 g admitted to neonatal intensive care unit within 2 hours after birth were enrolled in the study.The dynamic changes of serum TSP-1 and TGF-β1 levels in preterm infants were observed on 1st, 7th, 14th, and 28th day after birth.Preterm infants were divided into BPD group and non-BPD group according to the diagnostic criteria of BPD.Receiver operating characteristic(ROC) curve and area under curve(AUC)was used to analyze the predictive value of serum TSP-1 and TGF-β1 for preterm infants with BPD.Results:According to the diagnostic criteria of BPD, 38 cases were in the BPD group and 52 cases in the non-BPD group.There was no significant difference in gestational age, birth weight and gender between the two groups( P>0.05). The levels of TSP-1 and TGF-β1 in the serum of BPD group were gradually increased, which were significantly higher than those of non-BPD group on the 1st, 7th, 14th, and 28th day( P<0.001). ROC results showed that AUC of TSP-1, TGF-β1 and their combination for predicting BPD were 0.889(95% CI 0.819~0.959), 0.826(95% CI 0.743~0.910), and 0.923(95% CI 0.870~0.976), respectively.The sensitivity were 86.80%, 86.70%, 89.50%, and the specificity were 86.50%, 73.10%, 80.80%, respectively.Cutoff values of TSP-1 and TGF-β1 for predicting BPD were 44.50 μg/L and 6.13 μg/L, respectively. Conclusion:Combined detection of serum TSP-1 and TGF-β1 on the first day after birth has an early predictive value for BPD in preterm infants.
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Objective:To evaluate the efficacy and safety of early intratracheal drops of budesonide combined with pulmonary surfactant in the prevention of bronchopulmonary dysplasia(BPD).Methods:Embase, PubMed, Cochrane Library, CNKI and Wanfang database were searched from the establishment of library construction to February 2022.Literature selection, quality assessment and data extraction were conducted according to the inclusion and exclusion criteria, and Meta-analysis was performed on the included literature using Rev Man 5.3 software.Results:Nine randomised controlled studies were included in this study, with a total of 884 children, including 433 in the experimental group and 451 in the control group.The results showed that there was a statistically significant difference in the incidence of BPD between the two groups[ OR=0.40, 95% CI(0.29, 0.53), P<0.001], and there was no statistically significant difference in the morbidity between the two groups[ OR=0.65, 95% CI(0.34, 1.22), P=0.18]. The risks of retinopathy of prematurity[ OR=0.42, 95% CI(0.54, 1.28), P=0.40], patent ductus arteriosus[ OR=0.79, 95% CI(0.57, 1.10), P=0.17], intracranial hemorrhage[ OR=1.09, 95% CI(0.77, 1.53), P=0.63], necrotizing enterocolitis[ OR=0.89, 95% CI(0.55, 1.44), P=0.64], and neonatal septicemia[ OR=0.73, 95% CI(0.49, 1.08), P=0.11] occurred in the experimental group had no statistically significant differences compared to the control group (all P>0.05). Conclusion:Early postnatal intratracheal drops of budesonide combined with pulmonary surfactant can significantly reduce the incidence of BPD, and has no significant effect on mortality or short-term complications.
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Objective:To establish a neonatal rat bronchopulmonary dysplasia(BPD) model induced by hyperoxia, to detect the expression of miR-876-3p in the lung tissue, and to analyze the role of miR-876-3p in the occurrence and development of BPD, so as to provide a theoretical basis for the pathogenesis, prevention and treatment of BPD.Methods:Eighty newborn SD rats were randomly divided into hyperoxia group(FiO 2 60%) and air group(FiO 2 21%). Lung tissue samples were taken on the 1st, 7th, 14th and 21st day after birth, the pathological changes of lung tissue were observed.Quantitative real-time PCR technique was used to detect the expression level of miR-876-3p. Results:Within 21 days after birth, with the prolongation of hyperoxia exposure time, the general growth of rats in hyperoxia group were lower than those in air group[14 d: (35.46±1.62) g vs.(37.08±1.25) g; 21 d: (51.92±1.83) g vs.(58.87±2.43) g]( P<0.05). On the 14th and 21st day after birth, the radial alveolar counts in lung tissue of rats in hyperoxia group were significantly reduced compared with those in air group( P<0.05). On the 7th, 14th and 21st day after birth, the alveolar septal thickness of rats in air group were lower than those in hyperoxia group( P<0.05). The expression level of miR-876-3p in hyperoxia group decreased gradually and was significantly lower on the 7th, 14th and 21st day compared with air group at the same time points[7 d: (14.97±1.13) vs.(16.64±0.89); 14 d: (11.92±0.71) vs.(16.85±0.79); 21 d: (11.39±0.79) vs.(17.52±1.17)], and the differences were all statistically significant( P all<0.01). Conclusion:In this study, a new BPD model of neonatal rats can be induced by hyperoxia and the expression level of miR-876-3p in this model is decreased.The differential expression level of miR-876-3p may play a role in the occurrence and development of BPD.
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Many circular RNAs(circRNAs)have been discovered and identified as noncoding RNA in various organisms in a specie-, tissue-, disease-and developmental stage-specific manner, and have been demonstrated to play essential roles in myriad life processes, such as embryo and tissue development, aging, insulin secretion, vascular disease and cancer.The normal development of lung morphology, structure and function is the physiological basis of breath.Accumulating evidences have been demonstrated that circRNAs might be involved in lung development and play important roles in lung development and related diseases like bronchopulmonary dysplasia(BPD).This review will summarize the biological functions of circRNAs and focus particularly on the potential implications of circRNAs in lung development and BPD.
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Bronchopulmonary dysplasia(BPD)is one of the most serious lung disease in the small gestational preterm infants, which may affect their development in infancy and adult quality of life.Blood samples of premature infants are easy to be collected and detected, and their biological markers are helpful for early prediction of BPD, which is of great significance for reducing the incidence of severe BPD and improving the poor prognosis of infants.In recent years, a variety of biological markers have been found in cord blood and serum of premature infants, including matrix metalloproteinase 9, tissue inhibitor of metalloproteinases 1, soluble Klotho protein, vascular endothelial growth factor, interleukin and N-terminal pro-brain natriuretic peptides, etc., some of which have been applied in clinic.It has broad application prospect for screening high-risk premature infants with BPD and effectively predicting the occurrence and severity of early BPD.
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Bronchopulmonary dysplasia(BPD)is a severe complication in premature infants, and the pathogenesis remains complex, potentially involving pulmonary inflammatory injury and faulty reparative response.T-cell immaturity in preterm neonates and the upregulation of related harmful regulatory genes, as well as the imbalance of T-cell homeostasis, have been reported to contribute significantly to the development of inflammatory diseases.Growing evidence suggests that alterations in the levels and functions of T cell subsets may participate in the development of BPD, serving as a new avenue for BPD prevention and treatment.Herein, we summarize recent advancements in understanding the role of T lymphocytes in the pathogenesis of BPD.
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Due to the development of neonatal intensive care, the survival rate of very preterm infants and very low birth weight infants has been significantly improved, and the incidence of bronchopulmonary dysplasia (BPD) has been obviously increasing year by year.The pathogenesis of BPD has not been clear, it is considered that inflammation is an important link in the occurrence and development of BPD at present.Neutrophils can use their neutrophil extracellular traps (NETs) to capture and kill pathogens and reduce inflammation, but excessive formation of NETs is easy to induce inflammatory imbalance, so as to damage normal cells or tissues and participate in the pathophysiological process of BPD.This paper reviews the structure, formation, function and regulatory role of NETs in BPD, and the targeted treatment strategies and potential research directions of NETs in BPD.
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Bronchopulmonary dysplasia(BPD)is a chronic respiratory system disease that causes respiratory failure and death in premature infants, and hyperoxic exposure is the main risk factor for its occurrence.Cellular senescence describes a state of cell cycle blockade, and in recent years studies have confirmed that exposure to hyperoxia can cause cellular senescence.Cellular senescence plays a crucial role in the development of the lung epithelium, lung interstitium, pulmonary vasculature, and airways, and abnormal development of these tissues is associated with the development of BPD.Therefore, this paper takes cellular senescence and BPD as the starting point to review the mechanism of hyperoxia-induced cellular senescence in the occurrence and development of BPD and the anti-aging drugs currently applied in clinical practice, in order to provide a new direction for the prevention and treatment of BPD.
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Pulmonary hypertension(PH)is commonly seen in preterm infants with bronchopulmonary dysplasia(BPD)and is significantly associated with increased mortality.The pathophysiological basis of PH is pulmonary vascular dysplasia or remodeling, and airways hyperresponsiveness.At present, management of BPD-PH should be comprehensive supportive therapy and focus on targeted pharmacotherapies, including various pulmonary vasodilators with different vasoactive mechanisms, such as phosphodiesterase inhibitors, endothelin receptor antagonists and prostaglandins analogs.However, although expert consensus recommends targeted pulmonary arterial hypertension therapy, high-quality clinical studies on the safety and efficacy of these drugs are few.Pulmonary vascular remodeling inhibitors and stem cell therapy have enormous potential to reduce pulmonary hypertension and further research and more data are needed.
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Bronchopulmonary dysplasia(BPD), a common respiratory disease in premature infants, leads to poor long-term prognosis.The crosstalk between the gut and lung which can be mediated by microbiota is known as the gut-lung axis.Recently, an increasing amount of evidence has indicated that the gut microbiota is closely related to the pathogenesis of many respiratory diseases.The gut-lung axis affects the occurrence and development of BPD through microbiota translocation and regulation of immune pathways.At present, the relationship between the gut-lung axis and BPD is still in the research stage and exploring the potential association may help to search early markers and new therapies for BPD.In order to provide insights into preventing and treating BPD, this review describes the relationship between the gut-lung axis and BPD.