Lung

, Volume 186, Issue 2, pp 75–89

Prevention and Treatment of Bronchopulmonary Dysplasia: Contemporary Status and Future Outlook

Article

DOI: 10.1007/s00408-007-9069-z

Cite this article as:
Cerny, L., Torday, J.S. & Rehan, V.K. Lung (2008) 186: 75. doi:10.1007/s00408-007-9069-z

Abstract

Despite tremendous advances in neonatology, bronchopulmonary dysplasia (BPD) remains a major cause of morbidity and mortality among premature infants. Any intervention that would reduce the risk of BPD or improve its outcome is likely to have substantial clinical and financial benefits. However, there is a clear lack of an effective agent for the treatment and/or prevention of BPD. This is due to an incomplete understanding of the molecular mechanisms involved in its pathogenesis. Taking a basic biological approach, our laboratory has discovered that disruption of normal alveolar homeostatic signaling is centrally involved in this process. Using a number of in vitro and in vivo models, our laboratory has demonstrated that stabilization of the normal alveolar homeostatic signaling pathway(s) can prevent and/or rescue the molecular injuries caused by the insults that lead to BPD. Here, we review the existing approaches to prevent and treat BPD and then, based on our insights into the pathogenesis of BPD, we propose novel and innovative therapeutic options that impact the disease on a cell/molecular level, unlike most of the current treatments available for BPD.

Keywords

Bronchopulmonary dysplasiaChronic lung diseaseHyperoxiaInhaled nitric oxideParathyroid hormone-related proteinPeroxisome proliferator-activated receptor γPrematuritySurfactantVolutrauma

Abbreviations

ADRP

Adipocyte differentiation-related protein

ATII

Alveolar type II

BPD

Bronchopulmonary dysplasia

CC10

Clara cell 10-kDa protein

CLD

Chronic lung disease

FDA

Food and Drug Administration

GA

Gestational age

iNO

Inhaled nitric oxide

IVH

Intraventricular hemorrhage

NCPAP

Nasal continuous positive airway pressure

NEC

Necrotizing enterocolitis

PaCO2

Arterial partial pressure of carbon dioxide

PDA

Patent ductus arteriosus

PTHrP

Parathyroid hormone-related protein

PVH

Periventricular hemorrhage

PVL

Periventricular leukomalacia

PPARγ

Peroxisome proliferator-activated receptor γ

ROP

Retinopathy of prematurity

RDS

Respiratory distress syndrome

RGZ

Rosiglitazone

SNIPPV

Synchronized nasal intermittent positive pressure ventilation

SIMV

Synchronized intermittent mechanical ventilation

TA

Tracheal aspirate

VLBWI

Very-low-birth-weight Infant

Wingless/int

Wnt

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Laura Cerny
    • 1
  • John S. Torday
    • 2
  • Virender K. Rehan
    • 3
    • 4
  1. 1.Harbor-UCLA-CHOC Neonatal Perinatal Fellowship ProgramLos Angeles Biomedical Research Institute at Harbor UCLA Medical CenterTorranceUSA
  2. 2.Departments of Pediatrics and Obstetrics and GynecologyLos Angeles Biomedical Research Institute at Harbor UCLA Medical CenterTorranceUSA
  3. 3.Department of Pediatrics and Neonatal Intensive Care UnitLos Angeles Biomedical Research Institute at Harbor UCLA Medical CenterTorranceUSA
  4. 4.Department of PediatricsLos Angeles Biomedical Research Institute at Harbor UCLA Medical CenterTorranceUSA