Current Pharmacologic Approaches for Prevention and Treatment of Bronchopulmonary Dysplasia

Tropea, Kristen A.; Christou, Helen

doi:10.1155/2012/598606

Cited by 27 publications

(22 citation statements)

References 89 publications

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“…Therefore, we suggest that ginger has antiinflammatory properties by decreasing neutrophil activation and migration into the lungs with evidence of reduced MPO activity in the lungs (9,11). Oxygen toxicity has a key role in the development of BPD (1)(2)(3)(4)(5)(6)(7). High concentrations of inspired oxygen can damage lung cells by the overproduction of cytotoxic reactive oxygen species (ROS) such as superoxide free radical, hydrogen peroxide, and hydroxyl free radical.…”

Section: Discussionmentioning

confidence: 99%

“…Prematurity is believed to be the most important contributing factor, in addition to other factors, including oxidative stress and inflammationmediated lung injury (chorioamnionitis), hyperoxia/ value-barotrauma, and genetic factors (5,6). Treatment strategies for the prevention of lung injury and appropriate induction of lung growth to avoid the development of BPD are still lacking (3,7). Therefore, new treatment options need to be identified for the prevention of severe injury to the lungs in the course of BPD.…”

Section: Introductionmentioning

confidence: 99%

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Ginger ( Zingiber officinale ) prevents severe damage to the lungs due to hyperoxia and inflammation

2018

Turk J Med Sci

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Background/aim: Hyperoxia-and inflammation-induced lung injury is an important cause of the development of bronchopulmonary dysplasia (BPD) in premature infants. We aimed to ascertain the beneficial effects of ginger (Zingiber officinale) on rat pups exposed to hyperoxia and inflammation.Materials and methods: Thirty-six newborn Wistar rats were randomly divided into 3 groups as the hyperoxia (95% O 2 ) + lipopolysaccharide (LPS) group, the hyperoxia + LPS + ginger-treated group, and the control/no treatment group (21% O 2 ). Pups in the hyperoxia + LPS + ginger group were administered oral ginger at a dose of 1000 mg/kg daily during the study period. Histopathologic, immunochemical (SMA and lamellar body), and biochemical evaluations including total antioxidant status (TAS), total oxidant status (TOS), malondialdehyde (MDA), myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and caspase-3 activities were performed. Results:Better weight gain and survival rates were shown in the hyperoxia + LPS + ginger group (P < 0.05). In the histopathologic and immunochemical evaluation, severity of lung damage was significantly reduced in the hyperoxia + LPS + ginger group, as well as decreased apoptosis (ELISA for caspase-3) (P < 0.05). Tissue TAS levels were significantly protected, and TOS, MDA, and MPO levels were significantly lower in the hyperoxia + LPS + ginger group (P < 0.05). Tissue TNF-α, IL-1β, and IL-6 concentrations were significantly decreased in the ginger-treated group (P < 0.05). Conclusion:Ginger efficiently reduced the lung damage and protected the lungs from severe damage due to hyperoxia and inflammation. Therefore, ginger may be an alternative option for the treatment of BPD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ginger ( Zingiber officinale ) prevents severe damage to the lungs due to hyperoxia and inflammation

2018

Turk J Med Sci

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“…Low-dose inhaled nitric oxide failed to reduce the incidence of BPD in very premature infants [8,22]. Further treatment modalities include the administration of caffeine/methylxanthines, diuretics and adequate nutritional support [4,23], and in the future stem cells may play a role in regenerative neonatology [24,25]. …”

Section: Potential Risks and Benefits Of High-dose Vitamin A Supplemementioning

confidence: 99%

Early Postnatal Additional High-Dose Oral Vitamin A Supplementation versus Placebo for 28 Days for Preventing Bronchopulmonary Dysplasia or Death in Extremely Low Birth Weight Infants

2014

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Background: Prematurity and the associated risk for bronchopulmonary dysplasia (BPD) remain a significant threat to extremely low birth weight (ELBW) infants. Vitamin A has been considered a therapeutic alternative in reducing the rate of BPD and mortality. Objectives: To investigate whether early postnatal, additional high-dose oral vitamin A supplementation for 28 days is more efficient in reducing BPD or death in ELBW infants than placebo treatment. Methods: This is a multicenter, double-blind RCT comparing postnatal high-dose oral vitamin A supplementation (5,000 IU vitamin A/kg/day vs. placebo) for 28 days in ELBW neonates requiring mechanical ventilation, noninvasive ventilatory support or supplemental oxygen at 24 h of age. The primary end point is the proportion of children who died before 36 weeks' gestational age or developed moderate or severe BPD. BPD is defined as the need for supplemental oxygen to maintain SaO₂ of ≥92% at rest at 36 weeks' postmenstrual age (PMA). Clinical secondary end points include the following: BPD (including mild form), intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, necrotizing enterocolitis, total number of days of mechanical ventilation and oxygen supplementation, and safety and tolerability of high-dose vitamin A supplementation. Results and Conclusions: The results of the NeoVitaA trial will provide robust data with regard to the efficacy of high-dose oral vitamin A supplementation in reducing the incidence of BPD or death at 36 weeks' PMA in ELBW infants.

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“…These studies demonstrated no improvement in mortality, days on mechanical ventilation, or incidence of BPD, arguing against targeting mast cells for mitigating CLD. However, they did not assess drug delivery in these studies, thus failing to provide evidence for effective drug deposition (59). It is feasible that other means of silencing mast cells will be developed that may be therapeutic for ameliorating CLD.…”

Section: Discussionmentioning

confidence: 99%

Mast cells and exosomes in hyperoxia-induced neonatal lung disease

Veerappan

Thompson

Savage

et al. 2016

American Journal of Physiology-Lung Cellular and Molecular Phys

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Chronic lung disease of prematurity (CLD) is a frequent sequela of premature birth and oxygen toxicity is a major associated risk factor. Impaired alveolarization, scarring, and inflammation are hallmarks of CLD. Mast cell hyperplasia is a feature of CLD but the role of mast cells in its pathogenesis is unknown. We hypothesized that mast cell hyperplasia is a consequence of neonatal hyperoxia and contributes to CLD. Additionally, mast cell products may have diagnostic and prognostic value in preterm infants predisposed to CLD. To model CLD, neonatal wild-type and mast cell-deficient mice were placed in an O2 chamber delivering hyperoxic gas mixture [inspired O2 fraction (FiO2 ) of 0.8] (HO) for 2 wk and then returned to room air (RA) for an additional 3 wk. Age-matched controls were kept in RA (FiO2 of 0.21). Lungs from HO mice had increased numbers of mast cells, alveolar simplification and enlargement, and increased lung compliance. Mast cell deficiency proved protective by preserving air space integrity and lung compliance. The mast cell mediators β-hexosaminidase (β-hex), histamine, and elastase increased in the bronchoalveolar lavage fluid of HO wild-type mice. Tracheal aspirate fluids (TAs) from oxygenated and mechanically ventilated preterm infants were analyzed for mast cell products. In TAs from infants with confirmed cases of CLD, β-hex was elevated over time and correlated with FiO2 Mast cell exosomes were also present in the TAs. Collectively, these data show that mast cells play a significant role in hyperoxia-induced lung injury and their products could serve as potential biomarkers in evolving CLD.

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Current Pharmacologic Approaches for Prevention and Treatment of Bronchopulmonary Dysplasia

Cited by 27 publications

References 89 publications

Ginger ( Zingiber officinale ) prevents severe damage to the lungs due to hyperoxia and inflammation

Ginger ( Zingiber officinale ) prevents severe damage to the lungs due to hyperoxia and inflammation

Early Postnatal Additional High-Dose Oral Vitamin A Supplementation versus Placebo for 28 Days for Preventing Bronchopulmonary Dysplasia or Death in Extremely Low Birth Weight Infants

Mast cells and exosomes in hyperoxia-induced neonatal lung disease

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