Naeem Anika, Ahmed Imtiaz, Silveyra Patricia
Pulmonary Immunology and Physiology Laboratory (PIP), Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Eur Med J (Chelmsf). 2019 Mar;4(1):20-29. Epub 2019 Mar 14.
Bronchopulmonary dysplasia (BPD) is a chronic inflammatory lung disease that affects thousands of newborns and infants every year. Although it is accepted that BPD results from lung damage and inflammation triggered by mechanical ventilation and hyperoxia, the causes and molecular events leading to lung damage and arrested development remain unknown. While recent advances in neonatal care have improved the survival of very low-weight infants, the rates of BPD have not improved accordingly. This is mainly due to our limited understanding of the disease's pathogenesis and the effective therapeutic options available. Current therapeutics for BPD involve ventilation management, steroid treatment, and administration of various agents, such as pulmonary surfactant, caffeine, vitamin A, nitric oxide, and stem cells. However, the efficacy of these agents in preventing and ameliorating BPD symptoms varies depending on the populations studied and the disease stage. As the field moves towards personalised therapeutic approaches, this review summarises clinical and experimental studies conducted in various models, aiming to increase understanding of the cellular and molecular mechanisms by which these agents can prevent or treat BPD. Due to the increasing number of extremely premature infants, it is imperative that we continue to work towards understanding the mechanisms of BPD pathogenesis and generating more effective therapeutic options.
支气管肺发育不良（BPD）是一种慢性炎症性肺部疾病，每年影响数千名新生儿和婴儿。虽然人们公认BPD是由机械通气和高氧引发的肺损伤和炎症所致，但导致肺损伤和发育停滞的原因及分子事件仍不清楚。尽管新生儿护理方面的最新进展提高了极低体重婴儿的存活率，但BPD的发生率并未相应改善。这主要是由于我们对该疾病发病机制以及现有有效治疗选择的了解有限。目前治疗BPD的方法包括通气管理、类固醇治疗以及使用各种药物，如肺表面活性物质、咖啡因、维生素A、一氧化氮和干细胞。然而，这些药物在预防和改善BPD症状方面的疗效因所研究的人群和疾病阶段而异。随着该领域朝着个性化治疗方法发展，本综述总结了在各种模型中进行的临床和实验研究，旨在增进对这些药物预防或治疗BPD的细胞和分子机制的理解。由于极早产儿数量不断增加，我们必须继续努力了解BPD发病机制，并开发更有效的治疗选择。
