Significant Grant Advances Care for Infants at Risk for Lung Disease
The Children's Hospital received a $3.5 million, five-year National Institutes of Health grant to research mechanisms in which premature babies develop bronchopulmonary dysplasia (BPD) or chronic lung disease.
"Based on laboratory studies at our Pediatric Heart Lung Center, we have developed the concept that disruption of normal growth of the lung's blood vessels, due to premature birth and injury to the lung, is a major cause of BPD and increases the risk for pulmonary hypertension in preemies," explained principal investigator Steven Abman, MD, director, Pediatric Heart Lung Center.
The group also proposed that early changes in blood levels of vascularprogenitor cells, proteins and molecules (or "biomarkers") that are involved in vascular development and genetic differences (polymorphisms) may identify premature infants who are at the highest risk for developing BPD and pulmonary hypertension.
"As survival of our tiniest premature babies has markedly improved, the number of infants who develop BPD has also increased," said Dr. Abman. "Mechanisms that lead to BPD and make some premature infants susceptible for BPD are poorly understood." In addition, Dr. Abman added, there is a growing number of infants with BPD who also develop severe pulmonary artery hypertension due to abnormalities of blood vessels and poor lung growth.
The study will measure early changes in biomarkers and polymorphisms in premature infants and will determine the presence and severity of BPD and pulmonary hypertension by serial echocardiograms (heart ultrasound studies) in premature newborns. The cardiac and respiratory course will be followed throughout infancy and early childhood to determine lateoutcomes.
"This is highly original research that extends our previous work in basic science studies and other clinical research regarding the impact of prematurity on the developing lung circulation and its role in causing BPD," Dr. Abman stated. "This work also follows our past studies that suggest that early treatment with inhaled nitric oxide (NO) can decrease BPD in some premature infants."
Dr. Abman hopes that at the study's end the clinical information garnered will help clinicians not only have a better understanding of how BPD developing and the reasons why, but will allow for earlier and novel therapies to prevent the severe morbidities associated with BPD.
BPD Study Team Members
- Steve Abman, MD, principal investigator; director, Pediatric
Heart Lung Center
- Peter Mourani, MD, major investigator, critical care
- Marci Sontag, PhD, preventative medicine and biometrics
- Vivek Balasubramaniam, MD, pulmonary medicine
- John Kinsella, MD, neonatology
- Adel Younasai, MD, cardiology
Members of the Pediatric Heart and Lung Center Laboratory and the
Pediatric Clinical and Translational Research Center
