Extremely low birth-weight babies are at risk for a chronic lung disease called bronchopulmonary dysplasia, or BPD. This condition can lead to death or long-term disease, but clinical measurements are unable to predict which of the tiny infants — who get care in hospital intensive-care units and often weigh just one and a half pounds — will develop BPD. University of Alabama at Birmingham (UAB) researchers now report discovery of a strong predictive biomarker for BPD, and they show a role for the biomarker in the pathogenesis of this neonatal lung disease. These results open the path to possible future therapies to prevent or lessen BPD, which is marked by inflammation and impaired lung development. This biomarker could also help neonatologists plan optimal management and risk stratification of their tiny patients, and it could guide targeted enrollment of high-risk infants into randomized trials of potentially novel treatment strategies. The UAB work, published online on March 8, 2018 in the journal JCI Insight, is an example of “bedside to bench” research. It began with prospective studies of extremely premature infants to identify potential biomarkers, and then proceeded to lab experiments using animal models and cells grown in culture to learn how the biomarker functions in disease progression. The study was led by Charitharth Vivek Lal, MD, Assistant Professor in the UAB Pediatrics Division of Neonatology, and it builds upon Dr. Lal’s 2016 report that early microbial imbalance in the airways of extremely premature infants is predictive for development of BPD.
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