Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
Eur J Pharmacol. 2020 Apr 15;873:172983. doi: 10.1016/j.ejphar.2020.172983. Epub 2020 Feb 1.
Bronchopulmonary dysplasia (BPD), which remains a major clinical problem for preterm infants, is caused mainly by hyperoxia, mechanical ventilation and inflammation. Many approaches have been developed with the aim of decreasing the incidence of or alleviating BPD, but effective methods are still lacking. Gasotransmitters, a type of small gas molecule that can be generated endogenously, exert a protective effect against BPD-associated lung injury; nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (HS) are three such gasotransmitters. The protective effects of NO have been extensively studied in animal models of BPD, but the results of these studies are inconsistent with those of clinical trials. NO inhalation seems to have no effect on BPD, although side effects have been reported. NO inhalation is not recommended for BPD treatment in preterm infants, except those with severe pulmonary hypertension. Both CO and HS decreased lung injury in BPD rodent models in preclinical studies. Another small gas molecule, hydrogen, exerts a protective effect against BPD. The nuclear factor erythroid-derived 2 (Nrf2)/heme oxygenase-1 (HO-1) axis seems to play a central role in the protective effect of these gasotransmitters on BPD. Gasotransmitters play important roles in mammals, but further clinical trials are needed to explore their effects on BPD.
支气管肺发育不良（BPD）仍然是早产儿的一个主要临床问题，主要由高氧、机械通气和炎症引起。已经开发了许多方法来降低或缓解 BPD 的发生率，但仍然缺乏有效的方法。气体信号分子是一类可以内源性产生的小分子气体，对 BPD 相关肺损伤具有保护作用；一氧化氮（NO）、一氧化碳（CO）和硫化氢（HS）是三种气体信号分子。NO 在 BPD 动物模型中的保护作用已经得到了广泛的研究，但这些研究的结果与临床试验的结果不一致。NO 吸入似乎对 BPD 没有影响，尽管有报道称存在副作用。除了严重肺动脉高压的早产儿，不建议将 NO 吸入用于治疗 BPD。在临床前研究中，CO 和 HS 均减轻了 BPD 啮齿动物模型中的肺损伤。另一种小分子气体氢气对 BPD 也具有保护作用。核因子红细胞衍生 2（Nrf2）/血红素加氧酶-1（HO-1）轴似乎在这些气体信号分子对 BPD 的保护作用中起核心作用。气体信号分子在哺乳动物中发挥着重要作用，但需要进一步的临床试验来探索它们对 BPD 的影响。
