Novel strategies for improving respiratory support and outcomes for very preterm babies

早产是新生儿患病和死亡的最常见原因，使其成为围产期医学中最严重和最昂贵的问题之一。早产儿的主要问题是肺不成熟及其对大脑发育的有害影响。大多数早产儿需要复苏，然后需要呼吸支持，通常需要几个星期。这是极其昂贵的，并给卫生保健系统带来了巨大的财政负担。此外，它还增加了呼吸系统疾病的风险，包括支气管肺发育不良和慢性肺部疾病，这些疾病可能会损害呼吸，并增加日后患哮喘等呼吸系统疾病的易感性。该计划的总体目标是改善早产儿的预后，包括减少肺损伤、改善呼吸健康和缩短住院时间。为了减轻早产对社区造成的健康负担，我们需要更多地了解早产如何改变新生儿时期和以后生活中肺部的正常发育。特别是，我们需要了解参与肺发育的细胞和分子过程，以便我们能够识别严重早产扰乱的基因网络和发育过程。这些知识是必要的，为管理和治疗早产引起的肺结构和功能改变提供更合理、更科学的依据。我们还需要开发更好的方法来复苏和呼吸这些婴儿，以便将肺损伤降至最低。研究小组由两名新生儿专家和三名生物医学研究科学家领导，他们有有效合作的记录。这个团队在国际上是独一无二的，因为它包括执业新生儿医生、呼吸生理学家和分子生物学家，他们合作卓有成效，被认为是各自领域的世界领先者。该团队还引入了新的人才，提供肺干细胞生物学、新型类固醇药物设计和临床随访方面的专业知识。总之，这个团队有潜力(A)极大地提高对早产对发育中的肺部的影响的了解，(B)改进复苏和呼吸技术，以及(C)将新知识转化为临床实践，以改善早产儿的结局。我们将利用有特色的动物模型来确定与胎儿肺发育有关的基因网络，以及这些基因网络是如何因早产而改变的。从胎儿到出生后生命的成功过渡对出生时的存活至关重要，但还需要更多的信息。利用新生的小羊和兔子，我们将尝试新的策略，以促进未成熟的小羊在出生时转变为有效的气体交换器官。关于肺充气的新数据

Very premature birth is the commonest cause of illness and death in newborn babies, making it one of the most serious and costly issues in perinatal medicine. The major problem suffered by very premature babies is lung immaturity and its associated harmful effects on brain development. Most very premature babies require resuscitation followed by ventilatory support,often for several weeks. This is extremely expensive and places an enormous financial burden on health care systems. Furthermore, it increases the risks of respiratory illnesses, including bronchopulmonary dysplasia and chronic lung disease which can impair breathing and increase susceptibility to respiratory disease such as asthma later in life. The overall aim of this program is to improve outcomes for very premature babies, including less lung injury, better respiratory health and shorter stays in hospitals. In order to reduce the health burden caused by very premature birth on the community we need to know more about how it alters the normal development of the lungs in the newborn period and into later life. In particular, we need to understand the cellular and molecular processes involved in lung development so that we can identify gene networks and developmental processes that are disrupted by severe premature birth. Such knowledge is necessary to provide a more rational, scientific basis for managing and treating the alterations in lung structure and function caused by premature birth. We also need to develop better ways of resuscitating and ventilating these infants so that lung injury is minimized.The research team is led by two neonatologists and three biomedical research scientists with a proven record of effective collaboration. This team is internationally unique in that it includes practicing neonatologists, respiratory physiologists and molecular biologists who have collaborated together productively and are regarded as world leaders in their respective fields. New talents have been brought into the team to provide expertise in pulmonary stem cell biology, the design of novel steroid drugs, and clinical follow-up. Together, this team has the potential (a) to greatly enhance the understanding of the impact of very premature birth on the developing lung, (b) to improve resuscitation and ventilation techniques, and (c) to translate the new knowledge into clinical practice to improve the outcome for prematurely born babies. Using well characterized animal models we will determine gene networks involved in fetal lung development and how these are altered by premature birth. The successful transition from fetal to postnatal life is critical for survival at birth but more information is needed. Using newborn lambs and rabbits, we will trial novel strategies for enhancing the transformation of the immaturelung into an effective gas exchange organ at birth. New data on lung aeratio