Oral Mucosal Microvascular Abnormalities: An Early Marker of Bronchopulmonary Dysplasia

Abstract

An abnormal pulmonary vasculature has been reported as an important component of bronchopulmonary dysplasia (BPD). We tested the hypothesis of an early abnormal vascular network pattern in infants with BPD. Fifteen infants with BPD (nine boys and six girls; gestational age 27.5 Ϯ 2.0 wk; birth weight 850 Ϯ 125 g) and 15 sex-and gestational age-matched infants (nine boys and six girls; gestational age 27.6 Ϯ 2.6 wk; birth weight 865 Ϯ 135 g) were examined on postnatal days 1 and 28. BPD infants showed a significantly higher prevalence of histologic chorioamnionitis (p ϭ 0.009), as well as higher intubation duration (p ϭ 0.0004), oxygen supplementation (p Ͻ 0.0001), and initial illness severity (p ϭ 0.0002) than the BPD-negative population. The lower gingival and vestibular oral mucosa was chosen as the study area. The blood vessel area was determined, and the oral vascular networks were characterized by analyzing their complexity ( Bronchopulmonary dysplasia (BPD) remains an important cause of mortality and morbidity in preterm infants. BPD is infrequent in infants with birth weight Ͼ1200 g or with gestation Ͼ30 wk, whereas among infants with birth weight Ͻ1000 g, a prevalence of~30% has been reported (1,2). To date, the pathogenesis of BPD remains unclear. Besides the well-known oxygen toxicity, volutrauma, and mechanical injury mechanisms (3), antenatal or postnatal inflammatory response (4,5) and leakage of plasticizers from endotracheal tubes (6,7) have been more recently associated with injury to the immature lung and/or the development of BPD. Delayed and disturbed formation of the terminal respiratory units have been reported in BPD (8), together with a disordered vascular development and a decreased production of angiogenic factors (9,10). In the past two decades it has been realized that many biologic systems have no characteristic length scale, thus having fractal or self-affine properties (11). Fractals are of great value in biology, where surface phenomena are of crucial importance and a number of complex anatomic structures, including arterial and venous trees, also display fractal-like geometry. We tested the hypothesis of an abnormal mucosa vascularization and network pattern in BPD by using fractal analysis. METHODSFifteen consecutive preterm infants with BPD (nine boys and six girls; gestational age 27.5 Ϯ 2.0 wk; birth weight 850 Ϯ 125 g) were examined, together with 15 sex-and gestational

Association of Chorioamnionitis With Bronchopulmonary Dysplasia Among Preterm Infants

“…Of 3170 potentially relevant studies, 158 (5.0%) met the inclusion criteria. The PRISMA flow diagram of the search process is shown in Figure 1.…”

Easily adaptable complexity measure for finite time series

“…LZ C [7], which has been effectively normalized [8] and widely applied [9]. We also propose a modified permutation method that naturally processes the equal values and significantly facilitates the transformation between the system-dependent symbolic sequence and the data-dependent permutation sequence (or permutations for short).…”

ORAL MUCOSAL MICROVASCULAR NETWORK ABNORMALITIES INDE NOVOMUTATION ACHONDROPLASIA

“…extracellular matrix) on angiogenesis and blood vessel geometry. 23,29 Recent research using fractal and chaotic analyses on oral mucosal vascular networks indicates that there is an increase in vascular complexity in other different proven or suspected ECM-related conditions including Ehlers-Danlos II/III syndrome, 30 Down syndrome, 31 infantile hypertrophic pyloric stenosis, 32 familial colorectal cancer syndromes, 33 true umbilical cord knots, 34 bronchopulmonary dysplasia 35 that ACH parents may carry a subclinical impairment of the ECM, leading to abnormal oral mucosal vascular network patterns. The results of the present study shows how complexity measures, such as the fractal dimension of oral mucosal microvascular networks, can be used to discover biological differences, with important relevance to disease, that are not demonstrable with traditional measures.…”