Association between vitamin D level and bronchopulmonary dysplasia: A systematic review and meta-analysis

Park, Hye Won; Lim, Gina; Park, Yong-Mean; Chang, Misoo; Son, Jae Sung; Lee, Ran

doi:10.1371/journal.pone.0235332

Cited by 26 publications

(22 citation statements)

References 76 publications

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“…In the present study, we showed that early vitamin D supplementation is significantly associated with the occurrence of BPD but not classification in preterm newborns. These results are in line with a comprehensive meta-analysis conducted by Park et al 7 They included 251 infants out of 909 infants were diagnosed with BPD.…”

Section: Discussionsupporting

confidence: 89%

Effects of early vitamin D supplementation on the prevention of bronchopulmonary dysplasia in preterm infants

Qiao

et al. 2022

Pediatric Pulmonology

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Background: Bronchopulmonary dysplasia (BPD) is a respiratory dysfunction caused by poor lung bronchial development, which may lead to long-term lung disease, threatening the lives of children. Studies have shown that premature infants with low vitamin D are highly associated with BPD. In this study, we aim to obtain insights into whether early vitamin D supplementation could prevent BPD in preterm infants. Methods: A total of 112 preterm infants were randomly divided into two groups: the control and vitamin D supplementation (VD) group. The VD group received vitamin D (800 IU/day) within 48 h at birth for consecutively 28 days. The serum levels of 25(OH)D 3 and C-reactive protein (CRP), IL6, and TNF-α were measured using ELISA assay. The arterial partial pressure of oxygen (PaO 2 ) and carbon dioxide (PaCO 2 ) was measured using an i-STAT analyzer. Results: The occurrence of BPD was decreased in the VD group compared with the control. The decreased serum 25(OH)D 3 was significantly elevated by supplementation with vitamin D. In addition, the serum inflammation factors (CRP, IL6, and TNF-α) were significantly reduced by vitamin D supplementation. Conclusion:We demonstrated that early vitamin D supplementation could significantly reduce BPD incidence in preterm infants. We showed that early vitamin D supplementation could significantly increase serum level of 25(OH)D 3 and reduce inflammatory response thereby preventing and reducing neonatal BPD.Limitation: Firstly, a larger sample size will be needed to be included to gain a comprehensive understanding of the protective effects of vitamin D and BPD mechanistically in preterm infants. Secondly, the pathophysiological process of BPD will need to be studied. In addition, the pathways that vitamin D is responsible for, need to be further researched.

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Section: Discussionsupporting

confidence: 89%

Effects of early vitamin D supplementation on the prevention of bronchopulmonary dysplasia in preterm infants

Qiao

et al. 2022

Pediatric Pulmonology

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“…Vitamin D is a promising candidate due to its anti-inflammatory and lung-growth-promoting properties. Its therapeutic potential is derived from the current meta-analysis that shows that low vitamin D levels at birth predispose the infants to BPD [ 88 ]. The experimental evidence suggests a significant benefit that can, at least partly, be attributed to the inhibition of key features of the inflammatory response [ 89 , 90 ].…”

Section: Clinical Approaches To Prevent Ros-induced Lung Injury and Bpdmentioning

confidence: 99%

Oxygen Toxicity to the Immature Lung—Part II: The Unmet Clinical Need for Causal Therapy

Behnke

Dippel

Choi

et al. 2021

IJMS

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Oxygen toxicity continues to be one of the inevitable injuries to the immature lung. Reactive oxygen species (ROS) production is the initial step leading to lung injury and, subsequently, the development of bronchopulmonary dysplasia (BPD). Today, BPD remains the most important disease burden following preterm delivery and results in life-long restrictions in lung function and further important health sequelae. Despite the tremendous progress in the pathomechanistic understanding derived from preclinical models, the clinical needs for preventive or curative therapies remain unmet. This review summarizes the clinical progress on guiding oxygen delivery to the preterm infant and elaborates future directions of research that need to take into account both hyperoxia and hypoxia as ROS sources and BPD drivers. Many strategies have been tested within clinical trials based on the mechanistic understanding of ROS actions, but most have failed to prove efficacy. The majority of these studies were tested in an era before the latest modes of non-invasive respiratory support and surfactant application were introduced or were not appropriately powered. A comprehensive re-evaluation of enzymatic, antioxidant, and anti-inflammatory therapies to prevent ROS injury is therefore indispensable. Strategies will only succeed if they are applied in a timely and vigorous manner and with the appropriate outcome measures.

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“…These epigenetics diets include polyphenols (epigallocatechin-3-gallate, resveratrol, genistein), vitamins (vitamins c and d, folate, choline), isothiocyanates, withaferin a, and selenium. Perinatal vitamin D deficiency and low vitamin D levels have played a crucial role in neonatal BPD [156,157]. Significantly, vitamin D can directly stimulate fetal pulmonary artery endothelial cell and alveolar epithelial type II cell growth and function to prevent BPD development in preterm infants [158].…”

Section: Perspectives For Treatment and Prevention Of Neonatal Chronic Lung Diseasementioning

confidence: 99%

Intrauterine Hypoxia and Epigenetic Programming in Lung Development and Disease

et al. 2021

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Clinically, intrauterine hypoxia is the foremost cause of perinatal morbidity and developmental plasticity in the fetus and newborn infant. Under hypoxia, deviations occur in the lung cell epigenome. Epigenetic mechanisms (e.g., DNA methylation, histone modification, and miRNA expression) control phenotypic programming and are associated with physiological responses and the risk of developmental disorders, such as bronchopulmonary dysplasia. This developmental disorder is the most frequent chronic pulmonary complication in preterm labor. The pathogenesis of this disease involves many factors, including aberrant oxygen conditions and mechanical ventilation-mediated lung injury, infection/inflammation, and epigenetic/genetic risk factors. This review is focused on various aspects related to intrauterine hypoxia and epigenetic programming in lung development and disease, summarizes our current knowledge of hypoxia-induced epigenetic programming and discusses potential therapeutic interventions for lung disease.

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Association between vitamin D level and bronchopulmonary dysplasia: A systematic review and meta-analysis

Cited by 26 publications

References 76 publications

Effects of early vitamin D supplementation on the prevention of bronchopulmonary dysplasia in preterm infants

Effects of early vitamin D supplementation on the prevention of bronchopulmonary dysplasia in preterm infants

Oxygen Toxicity to the Immature Lung—Part II: The Unmet Clinical Need for Causal Therapy

Intrauterine Hypoxia and Epigenetic Programming in Lung Development and Disease

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