Division of Neonatology, Neonatal Redox Biology Laboratory, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Neonatology, Neonatal Redox Biology Laboratory, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Free Radic Biol Med. 2019 Oct;142:138-145. doi: 10.1016/j.freeradbiomed.2019.01.038. Epub 2019 Feb 12.
Preterm birth is a primary cause of worldwide childhood mortality. Bronchopulmonary dysplasia, characterized by impaired alveolar and lung vascular development, affects 25-50% of extremely low birth weight (BW; <1 kg) infants. Abnormalities in lung function persist into childhood in affected infants and are second only to asthma in terms of childhood respiratory disease healthcare costs. While advances in the medical care of preterm infants have reduced mortality, the incidence of BPD has not decreased in the past 10 years. Reactive oxygen intermediates play a key role in the development of lung disease but, despite promising preclinical therapies, antioxidants have failed to translate into meaningful clinical interventions to decrease the incidence of lung disease in premature infants. In this review we will summarize the state of the art research developments in regards to antioxidants and premature lung disease and discuss the limitations of antioxidant therapies in order to more fully comprehend the reasons why therapeutic antioxidant administration failed to prevent BPD. Finally we will review promising therapeutic strategies and targets.
早产是全球儿童死亡的主要原因。支气管肺发育不良（bronchopulmonary dysplasia，BPD）的特征是肺泡和肺血管发育受损，影响了 25-50%极低出生体重（BW；<1kg）婴儿。受影响婴儿的肺功能异常持续到儿童期，在儿童期呼吸道疾病医疗费用方面仅次于哮喘。尽管早产儿医疗护理的进步降低了死亡率，但过去 10 年来，BPD 的发病率并未下降。活性氧中间体在肺部疾病的发展中起关键作用，但尽管有有前景的临床前治疗方法，抗氧化剂仍未能转化为有意义的临床干预措施，以降低早产儿肺部疾病的发病率。在这篇综述中，我们将总结抗氧化剂和早产儿肺部疾病的最新研究进展，并讨论抗氧化剂治疗的局限性，以便更全面地理解为什么治疗性抗氧化剂给药未能预防 BPD。最后，我们将回顾有前途的治疗策略和靶点。
