Bronchopulmonary dysplasia as a determinant of respiratory outcomes in adult life.
Bronchopulmonary dysplasia as a determinant of respiratory outcomes in adult life.
复制标题
DOI：
10.1002/ppul.25301
复制
发表时间：
2021-11
影响因子：
3.1
通讯作者：
McGrath-Morrow SA
中科院分区：
文献类型：
--
作者：
Collaco JM;McGrath-Morrow SA
呼吸道疾病在早产儿中很常见，其典型类型为支气管肺发育不良（BPD）。在美国，BPD每年影响大约50，000名早产儿，其发病率和死亡率与其病理学（肺泡、气道和肺血管发育不良）相关。随着年龄的增长，预测这些儿童患慢性呼吸道疾病的可能性和严重程度是困难的，并且由于缺乏一致的表型而变得更加复杂。了解这一问题的实际范围的障碍包括很少的纵向研究，信息有限的小型回顾性研究和不断变化的景观在新生儿重症监护室的治疗，影响长期的呼吸结果。因此，早产引起的成人呼吸道疾病的真正负担目前尚不清楚。然而，有限的数据表明，相当大比例的有BPD病史的儿童有长期的呼吸道症状和持续的气流阻塞，与成年后肺功能轨迹的改变有关。具有可变支气管扩张剂反应性的小气道疾病是有BPD病史的成人中肺功能障碍的最常见表现。其病因尚不清楚，但是，在一些有BPD病史的成年人中，发育性嗅觉障碍可能是气流阻塞的基础。这种类型的流量限制类似于无吸烟史的慢性阻塞性肺病（COPD）老年人。目前还不清楚有BPD病史的人的肺功能异常是否是静态的，或者与对照组相比，这些BPD患者的肺功能随着年龄的增长而加速下降。虽然已经确定了一些更重要的肺功能介质，如烟草烟雾和呼吸道感染，但还需要更多的工作来确定在整个生命周期中保护早产儿肺功能的最佳方法。
Respiratory disease is unfortunately common in preterm infants with the archetype being bronchopulmonary dysplasia (BPD). BPD affects approximately 50,000 preterm infants in the U.S. annually with substantial morbidity and mortality related to its pathology (alveolar, airway, and pulmonary vasculature maldevelopment). Predicting the likelihood and severity of chronic respiratory disease in these children as they age is difficult and compounded by the lack of consistent phenotyping. Barriers to understanding the actual scope of this problem include few longitudinal studies, information limited by small retrospective studies and the ever-changing landscape of therapies in the NICU that affect long-term respiratory outcomes. Thus, the true burden of adult respiratory disease caused by premature birth is currently unknown. Nevertheless, limited data suggest that a substantial percentage of children with a history of BPD have long-term respiratory symptoms and persistent airflow obstruction associated with altered lung function trajectories into adult life. Small airway disease with variable bronchodilator responsiveness, is the most common manifestation of lung dysfunction in adults with a history of BPD. The etiology of this is unclear however, developmental dysanapsis may underlie the airflow obstruction in some adults with a history of BPD. This type of flow limitation resembles that of aging adults with chronic obstructive lung disease (COPD) with no history of smoking. It is also unclear whether lung function abnormalities in people with a history of BPD are static or if these individuals with BPD have a more accelerated decline in lung function as they age compared to controls. While some of the more significant mediators of lung function such as tobacco smoke and respiratory infections have been identified, more work is necessary to identify the best means of preserving lung function for individuals born prematurely throughout their lifespan.
登录
查看更多内容
影响因子：
5.1
作者：
Ambalavanan, Namasivayam;Cotten, C. Michael;Page, Grier P.;Carlo, Waldemar A.;Murray, Jeffrey C.;Bhattacharya, Soumyaroop;Mariani, Thomas J.;Cuna, Alain C.;Faye-Petersen, Ona M.;Kelly, David;Higgins, Rosemary D.
通讯作者：
Higgins, Rosemary D.
影响因子：
8
作者：
Chan, Johnny Y. C.;Stern, Debra A.;Martinez, Fernando D.
通讯作者：
Martinez, Fernando D.
影响因子：
76.2
作者：
Bui, Dinh S.;Lodge, Caroline J.;Dharmage, Shyamali C.
通讯作者：
Dharmage, Shyamali C.
影响因子：
5.6
作者：
Badyda, Artur;Gayer, Anna;Dabrowiecki, Piotr
通讯作者：
Dabrowiecki, Piotr
影响因子：
3.1
作者：
Collaco, Joseph M.;Morrow, Michael;McGrath-Morrow, Sharon A.
通讯作者：
McGrath-Morrow, Sharon A.