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Title: | Pulmonary hypertension associated with bronchopulmonary dysplasia in preterm infants. | Authors: | Theda C.;Lao J.C.;Berger P.J.;Nold M.F.;Nold-Petry C.A. ;Bui C.B.;Pang M.A.;Sehgal A. | Institution: | (Bui, Pang, Lao, Berger, Nold, Nold-Petry) Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia (Bui, Pang, Sehgal, Lao, Berger, Nold, Nold-Petry) Department of Paediatrics, Monash University, Melbourne, Victoria, Australia (Sehgal, Nold) Monash Newborn, Monash Health, Clayton, Victoria, Australia (Theda) The Royal Women's Hospital, Melbourne, Victoria, Australia | Issue Date: | 19-Oct-2017 | Copyright year: | 2017 | Publisher: | Elsevier Ireland Ltd | Place of publication: | Ireland | Publication information: | Journal of Reproductive Immunology. 124 (pp 21-29), 2017. Date of Publication: November 2017. | Journal: | Journal of Reproductive Immunology | Abstract: | Bronchopulmonary dysplasia (BPD) and BPD-associated pulmonary hypertension (BPD-PH) are chronic inflammatory cardiopulmonary diseases with devastating short- and long-term consequences for infants born prematurely. The immature lungs of preterm infants are ill-prepared to achieve sufficient gas exchange, thus usually necessitating immediate commencement of respiratory support and oxygen supplementation. These therapies are life-saving, but they exacerbate the tissue damage that is inevitably inflicted on a preterm lung forced to perform gas exchange. Together, air-breathing and necessary therapeutic interventions disrupt normal lung development by aggravating pulmonary inflammation and vascular remodelling, thus frequently precipitating BPD and PH via an incompletely understood pathogenic cascade. BPD and BPD-PH share common risk factors, such as low gestational age at birth, fetal growth restriction and perinatal maternal inflammation; however, these risk factors are not unique to BPD or BPD-PH. Occurring in 17-24% of BPD patients, BPD-PH substantially worsens the morbidity and mortality attributable to BPD alone, thus darkening their outlook; for example, BPD-PH entails a mortality of up to 50%. The absence of a safe and effective therapy for BPD and BPD-PH renders neonatal cardiopulmonary disease an area of urgent unmet medical need. Besides the need to develop new therapeutic strategies, a major challenge for clinicians is the lack of a reliable method for identifying babies at risk of developing BPD and BPD-PH. In addition to discussing current knowledge on pathophysiology, diagnosis and treatment of BPD-PH, we highlight emerging biomarkers that could enable clinicians to predict disease-risk and also optimise treatment of BPD-PH in our tiniest patients.Copyright © 2017 Hudson Institute of Medical Research | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.jri.2017.09.013 | Link to associated publication: | Click here for full text options | PubMed URL: | 29035757 [http://www.ncbi.nlm.nih.gov/pubmed/?term=29035757] | ISSN: | 0165-0378 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/38475 | Type: | Review | Subjects: | lung injury lung vascular resistance newborn nonhuman oligohydramnios oxygen therapy oxygen toxicity pathogenesis pediatrician persistent pulmonary hypertension/di [Diagnosis] persistent pulmonary hypertension/et [Etiology] practice guideline prediction *prematurity priority journal *pulmonary hypertension/di [Diagnosis] *pulmonary hypertension/dt [Drug Therapy] *pulmonary hypertension/et [Etiology] pulmonary hypertension/dt [Drug Therapy] review risk factor twins arginine/ec [Endogenous Compound] beta catenin/ec [Endogenous Compound] biological marker/ec [Endogenous Compound] bosentan/dt [Drug Therapy] bosentan/pd [Pharmacology] caffeine/dt [Drug Therapy] corticosteroid/dt [Drug Therapy] corticosteroid/pd [Pharmacology] dexamethasone/dt [Drug Therapy] dexamethasone/pd [Pharmacology] diuretic agent/dt [Drug Therapy] endothelial nitric oxide synthase/ec [Endogenous Compound] extracellular superoxide dismutase/ec [Endogenous Compound] free radical/ec [Endogenous Compound] genomic DNA/ec [Endogenous Compound] glucocorticoid/dt [Drug Therapy] glucocorticoid/pd [Pharmacology] histone deacetylase 2/ec [Endogenous Compound] isoprostane derivative/ec [Endogenous Compound] lung surfactant/dt [Drug Therapy] methyl CpG binding protein 2/ec [Endogenous Compound] microRNA/ec [Endogenous Compound] nitric oxide/dt [Drug Therapy] nitric oxide/ih [Inhalational Drug Administration] oxygen/to [Drug Toxicity] peroxisome proliferator activated receptor gamma/ec [Endogenous Compound] phosphodiesterase V/ec [Endogenous Compound] reactive oxygen metabolite/ec [Endogenous Compound] sildenafil/dt [Drug Therapy] angiogenesis artificial ventilation disease association disease classification disease severity echocardiography epigenetics extremely low birth weight genetic predisposition gestational age heart catheterization histone modification human infant intrauterine growth retardation lung artery pressure *lung dysplasia/di [Diagnosis] *lung dysplasia/dt [Drug Therapy] *lung dysplasia/et [Etiology] lung dysplasia/dt [Drug Therapy] sildenafil/pd [Pharmacology] somatomedin C/ec [Endogenous Compound] somatomedin C receptor/ec [Endogenous Compound] vasculotropin receptor 2/ec [Endogenous Compound] infant intrauterine growth retardation lung artery pressure *lung dysplasia / *diagnosis / *drug therapy / *etiology lung dysplasia / drug therapy lung injury lung vascular resistance newborn nonhuman oligohydramnios oxygen therapy oxygen toxicity pathogenesis pediatrician persistent pulmonary hypertension / diagnosis / etiology practice guideline prediction *prematurity priority journal *pulmonary hypertension / *diagnosis / *drug therapy / *etiology pulmonary hypertension / drug therapy Review risk factor twins epigenetics echocardiography disease severity angiogenesis artificial ventilation extremely low birth weight genetic predisposition gestational age heart catheterization histone modification human disease classification disease association |
Type of Clinical Study or Trial: | Review article (e.g. literature review, narrative review) |
Appears in Collections: | Articles |
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