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重新启动肺发育:支气管肺发育不良管理的新方法。

Reinitiating lung development: a novel approach in the management of bronchopulmonary dysplasia.

机构信息

Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, China.

出版信息

Respir Res. 2024 Oct 24;25(1):384. doi: 10.1186/s12931-024-02996-8.

Abstract

Bronchopulmonary dysplasia (BPD) is the predominant chronic lung disease in preterm infants, linked with various adverse long-term outcomes. Multiple prenatal and postnatal risk factors can impede lung development, leading to BPD. Current management of BPD relies heavily on pharmacotherapies and alterations in ventilatory strategies. However, these interventions only mitigate BPD symptoms without addressing underlying alveolar, vascular, structural, and functional deficiencies. Given the retarded lung development in infants with BPD and the limitations of existing modalities, new therapeutic approaches are imperative. The induced differentiation of stem/progenitor cells and the spatiotemporal expression patterns of growth factors associated with lung developmental processes are critical for lung development reactivation in BPD, which focuses on stimulating pulmonary vasculogenesis and alveolarization. This review summarizes the process of lung development and offers a comprehensive overview of advancements in therapies designed to reinitiate lung development in BPD. Furthermore, we assessed the potential of these therapies for maintaining lung homeostasis and effectively restoring pulmonary structure and function through stem/progenitor cells and growth factors, which have been widely researched.

摘要

支气管肺发育不良(BPD)是早产儿中主要的慢性肺部疾病,与各种不良的长期结局相关。多种产前和产后的危险因素会阻碍肺部发育,导致 BPD。目前,BPD 的治疗主要依赖于药物治疗和通气策略的改变。然而,这些干预措施只能减轻 BPD 症状,而不能解决肺泡、血管、结构和功能的根本缺陷。鉴于 BPD 婴儿的肺部发育迟缓以及现有方式的局限性,新的治疗方法迫在眉睫。诱导干细胞/祖细胞的分化以及与肺发育过程相关的生长因子的时空表达模式,对于 BPD 中的肺发育再激活至关重要,其重点是刺激肺血管生成和肺泡化。本综述总结了肺发育的过程,并全面概述了旨在重新启动 BPD 中肺发育的治疗方法的进展。此外,我们评估了这些疗法通过干细胞/祖细胞和生长因子来维持肺内稳态并有效恢复肺结构和功能的潜力,这些疗法已经得到了广泛的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/488a/11515458/c0d8256abab5/12931_2024_2996_Fig1_HTML.jpg

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