What is Bronchopulmonary Dysplasia?
Bronchopulmonary Dysplasia (BPD) is a diagnosis most commonly given to premature newborns. In children, BPD is also the most common cause of Pulmonary Hypertension (PH). Premature babies often develop respiratory distress syndrome because their body struggles to produce surfactant. Surfactant is a fluid that helps keep the lungs open. As a result, the child can’t take in an adequate amount of oxygen and are given oxygen therapy. Respiratory distress syndrome typically improves over time, but when babies still require oxygen therapy after their due date, they are diagnosed with BPD.
Researchers know that understanding a patient’s risk of developing BPD can improve their outcomes as it allows doctors time to implement preventive strategies. This is especially vital for the moderate and severe forms of the condition. While research has been done examining clinical and analytical factors which may predict BPD, scientists have yet to find a biomarker predictive of the condition.
Thankfully, new research on biomarkers in BPD has just been conducted by a group of scientists and published on Plos One. Their peer-reviewed study was titled Exploring clinical, echocardiographic and molecular biomarkers to predict bronchopulmonary dysplasia.
This study examined clinical factors, echocardiographic factors, and molecular biomarkers to determine which was best for predicting BPD. Their hypothesis was that molecular biomarkers would be the most predictive of the condition. Specifically, they focused their examination on the biomarker ET-1.
50 premature newborns participated in the study. Their mean gestational age was just 26 weeks. Each week from birth to 36 weeks, the children’s clinical variables, echocardiographic variables, and molecular biomarkers were documented. Researchers utilized blood samples and tracheal aspirate samples in their analysis of biomarkers.
Sadly, three patients passed away and were therefore excluded from the study. 35 of the patients ended up developing BPD. That equates to 74.5% of the participants. Of these, 14 developed mild BPD, 15 developed moderate BPD, and 6 developed severe BPD. A logistical regression was then performed to identify which of the variables were most predictive of the diagnosis. One model used just clinical and echocardiographic factors and one model used these two factors plus the biomarker ET-1.
The researchers ultimately found that the addition of the ET-1 biomarker did improve the predictive value of the model. However, because their sample size was so small, they cannot confirm the true role of ET-1 in predicting BPD. That said, their study clearly confirms that more research into the role of ET-1 is warranted.
Regardless of the predictive quality of ET-1 however, these researchers do contend that the use of just clinical and echocardiographic factors is more practical for physicians. The examination of ET-1 requires special laboratory techniques and therefore is difficult to use on a regular basis.
In sum, ET-1 needs further investigation. But in the meantime, using a combination both clinical and echocardiographic factors as opposed to just one or the other, will provide physicians the best insight into patent’s risk of developing moderate to severe BPD.
You can read the full results from this study here.