Biomarkers of Immunologic Function and Preterm Respiratory Outcomes

描述（由申请人提供）：这是辛辛那提儿童医院新生儿和肺部服务分部作为临床中心参与NHLBI早产儿和呼吸结局项目（PROP）的提案。临床产科服务每年接收约140名出生体重<1公斤的婴儿。 这些婴儿中约有20%死亡，约40%将患有BPD。该中心每年可提供至少100例患者或400例患者超过4年的合作研究，以更好地表征BPD的表型，并确定生物标志物，以预测幸存者的lyr肺部结局。新生儿和肺服务有一个上级的研究基础设施和长期的生产基础和转化研究有关肺发育，肺损伤，和BPD的历史。这项临床研究将与我们的NICHD -新生儿研究网络网站以及其他资助的临床研究和随访活动合作进行。该研究项目包括3个目的，以验证免疫调节有助于BPD的发生，进展和消退的假设，这些免疫因素是预测BPD结局的生物标志物。目的1将测试BPD进展期间持续的促炎性Th 17淋巴细胞活化。目的2将使用唾液样本评估蛋白聚糖表型和/或分泌基因型是否预测重度BPD或死亡。目的3将询问表面活性蛋白SP-A和SP-D是否可预测出生时的BPD，以及血液水平是否可识别早期肺损伤进展为BPD。 这些测量值将与临床数据、36周校正胎龄时的BPD结局以及通过肺部健康问卷和婴儿肺功能研究评价的1年肺部结局相关。该中心与其他中心之间的合作活动将通过数据和样本核心来促进，以处理和整合所有信息和样本。该中心预计将我们对每个目标的样本评估扩展到其他中心，并期待着参与合作，多中心的方法来分型BPD。(End摘要） 相关性：该项目将评估最小和最高风险婴儿的免疫功能调节剂，以评估早产儿的主要不良肺部结局- BPD。这些评估针对生物标志物，以预测疾病的严重程度和1年。目标是开发新的治疗策略。

DESCRIPTION (provided by applicant): This is a proposal for the Cincinnati Children's Hospital Division of Neonatology and pulmonary services to participate as a Clinical Center in the NHLBI Prematurity and Respiratory Outcomes Program (PROP). The clinical neonatology services admit about 140 infants/year with birth weights <1kg. About 20% of these infants die and about 40% will have BPD. This Center can contribute at least 100 patients/year or 400 patients over 4yrs for collaborative studies to better characterize the phenotype of BPD and to identify biomarkers to predict lyr pulmonary outcomes of survivors. The neonatal and pulmonary services have a superior research infrastructure and long histories of productive basic and translational research related to lung development, lung injury, and BPD. This clinical research will be performed cooperatively with our NICHD - Neonatal Research Network site and with other funded clinical research and follow-up activities. The research project includes 3 Aims to test the hypothesis that immune regulation contributes to the onset, progression, and resolution of BPD and those immune factors are biomarkers for predicting BPD outcomes. Aim 1 will test for sustained pro-inflammatory Th17 lymphocyte activation during the progression of BPD. Aim 2 will evaluate if proteoglycan phenotype and/or secretor genotype predict severe BPD or death using saliva samples. Aim 3 will ask if surfactant proteins SP-A and SP-D predict BPD at birth and if blood levels identify lung injury progressing to BPD during early life. These measurements will be correlated with clinical data, BPD outcomes at 36wks corrected gestational age, and 1yr pulmonary outcomes evaluated by a lung health questionnaire and infant pulmonary function studies. Collaborative activities between this Center and other Centers will be facilitated by a Data and Sample Core for processing and integrating all information and samples. The Center anticipates extending our sample assessments for each Aim to other Centers and looks forward to participating in collaborative, multi-center approaches to phenotyping BPD. (End of Abstract) Relevance: The project will assess modulators of immune function in the smallest and most high-risk infants for the major adverse pulmonary outcome of prematurity - BPD. These evaluations are directed toward biomarkers to predict disease severity and 1 yr. outcomes with a goal of developing new treatment strategies.