Understanding the Impact of Infection, Inflammation, and Their Persistence in the Pathogenesis of Bronchopulmonary Dysplasia.
Understanding the Impact of Infection, Inflammation, and Their Persistence in the Pathogenesis of Bronchopulmonary Dysplasia.
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DOI：
10.3389/fmed.2015.00090
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发表时间：
2015
影响因子：
3.9
通讯作者：
Bhandari V
中科院分区：
文献类型：
--
作者：
Balany J;Bhandari V
遗传和环境因素的协同作用作用于早产儿未成熟的肺，炎症是共同的因素，导致婴儿最常见的慢性肺部疾病--支气管肺发育不良症( - )的多因素起源。围产期不良的感染/炎症暴露加上侵入性机械通气、暴露在高氧血症和败血症等额外的侮辱，会导致持续性的免疫失调。在这篇综述文章中，我们试图分析和巩固目前关于持续性产前和产后炎症在BPD发病机制中所起作用的知识。而早期炎症反应的一些参数(中性粒细胞、细胞因子等)在几天到几周的有害刺激下可能检测不到它们，它们已经启动了炎症过程/免疫级联的信号通路，并影响了BPD肺的永久性结构和功能缺陷。因此，旨在预防/改善BPD的转化性研究需要在早期阶段集中于抑制炎症反应，以防止导致肺损伤并损害愈合的一连串事件，从而导致以BPD为特征的肺泡简化和血管形成失调的病理肺表型。
The concerted interaction of genetic and environmental factors acts on the preterm human immature lung with inflammation being the common denominator leading to the multifactorial origin of the most common chronic lung disease in infants – bronchopulmonary dysplasia (BPD). Adverse perinatal exposure to infection/inflammation with added insults like invasive mecha nical ventilation, exposure to hyperoxia, and sepsis causes persistent immune dysregulation. In this review article, we have attempted to analyze and consolidate current knowledge about the role played by persistent prenatal and postnatal inflammation in the pathogenesis of BPD. While some parameters of the early inflammatory response (neutrophils, cytokines, etc.) may not be detectable after days to weeks of exposure to noxious stimuli, they have already initiated the signaling pathways of the inflammatory process/immune cascade and have affected permanent defects structurally and functionally in the BPD lungs. Hence, translational research aimed at prevention/amelioration of BPD needs to focus on dampening the inflammatory response at an early stage to prevent the cascade of events leading to lung injury with impaired healing resulting in the pathologic pulmonary phenotype of alveolar simplification and dysregulated vascularization characteristic of BPD.