Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center Boston, MA, USA.
Front Pharmacol. 2015 Feb 16;6:12. doi: 10.3389/fphar.2015.00012. eCollection 2015.
As more infants are surviving at younger gestational ages, bronchopulmonary dysplasia (BPD) remains as a frequent neonatal complication occurring after preterm birth. The multifactorial nature of the disease process makes BPD a challenging condition to treat. While multiple pharmacologic therapies have been investigated over the past two decades, there have been limited advances in the field. Often multiple therapies are used concurrently without clear evidence of efficacy, with potential for significant side effects from drug-drug interactions.
Systematic literature review.
Although there is physiologic rationale for the use of many of these therapies, none of them has single-handedly altered the incidence, severity, or progression of BPD. Future research should focus on developing clinically significant end-points (short and long term respiratory assessments), investigating biomarkers that accurately predict risk and progression of disease, and creating appropriate stratification models of BPD severity. Applying a multi-modal approach to the study of new and existing drugs should be the most effective way of establishing the optimal prevention and treatment regimens for BPD.
随着越来越多的婴儿在更小的胎龄存活,支气管肺发育不良(BPD)仍然是早产儿出生后常见的新生儿并发症。该疾病过程的多因素性质使得 BPD 的治疗具有挑战性。尽管在过去的二十年中已经研究了多种药物治疗方法,但该领域的进展有限。通常同时使用多种治疗方法,而没有明确的疗效证据,并且存在药物相互作用的潜在严重副作用。
系统文献回顾。
尽管这些治疗方法中的许多方法在生理学上都有其合理依据,但没有一种方法可以单独改变 BPD 的发生率、严重程度或进展。未来的研究应集中于开发具有临床意义的终点(短期和长期呼吸评估),研究准确预测疾病风险和进展的生物标志物,并建立 BPD 严重程度的适当分层模型。对新的和现有的药物进行多模式研究应该是确定 BPD 最佳预防和治疗方案的最有效方法。