New advances in the understanding and diagnoses of neonatal lung diseases

Keyword(s):  
2015 ◽  
Vol 308 (2) ◽  
pp. L141-L146 ◽  
Author(s):  
Yvette N. Martin ◽  
Logan Manlove ◽  
Jie Dong ◽  
William A. Carey ◽  
Michael A. Thompson ◽  
...  

Supplemental oxygen, used to treat hypoxia in preterm and term neonates, increases the risk of neonatal lung diseases, such as bronchopulmonary dysplasia (BPD) and asthma. There is a known sex predilection for BPD, but the underlying mechanisms are not clear. We tested the hypothesis that altered, local estradiol following hyperoxia contributes to pathophysiological changes observed in immature lung. In human fetal airway smooth muscle (fASM) cells exposed to normoxia or hyperoxia, we measured the expression of proteins involved in estrogen metabolism and cell proliferation responses to estradiol. In fASM cells, CYP1a1 expression was increased by hyperoxia, whereas hyperoxia-induced enhancement of cell proliferation was blunted by estradiol. Pharmacological studies indicated that these effects were attributable to upregulation of CYP1a1 and subsequent increased metabolism of estradiol to a downstream intermediate 2-methoxyestradiol. Microarray analysis of mouse lung exposed to 14 days of hyperoxia showed the most significant alteration in CYP1a1 expression, with minimal changes in expression of five other genes related to estrogen receptors, synthesis, and metabolism. Our novel results on estradiol metabolism in fetal and early postnatal lung in the context of hyperoxia indicate CYP1a1 as a potential mechanism for the protective effect of estradiol in hyperoxia-exposed immature lung, which may help explain the sex difference in neonatal lung diseases.


2014 ◽  
pp. 249-262
Author(s):  
Thordur Thorkelsson ◽  
Gunnlaugur Sigfusson
Keyword(s):  

Neonatology ◽  
2018 ◽  
pp. 1-14
Author(s):  
Virgilio P. Carnielli ◽  
Paola E. Cogo

2014 ◽  
Vol 27 (6) ◽  
pp. 717 ◽  
Author(s):  
Lia Oliveira ◽  
Joana Coelho ◽  
Rosário Ferreira ◽  
Teresa Nunes ◽  
Ana Saianda ◽  
...  

<strong>Introduction:</strong> Long-term home oxygen therapy is indicated for patients with chronic hypoxemia. We intend to describe pediatric population on long-term home oxygen therapy followed-up at Pediatric Respiratory Unit of a tertiary care hospital between 2003-2012 and to compare with previous 1991-2000 review; to verify conformity with international and national recommendations and need for specific pediatric national guidelines, non-existent in Portugal.<br /><strong>Material and Methods:</strong> Retrospective, descriptive and comparative study based on clinical files review. Review the guidelines for oxygen therapy in pediatric population.<br /><strong>Results:</strong> We studied 86 patients (59.3% males). The median age at the beginning of oxygen therapy was 0.0 (0.0-216.0) months, with a median duration of 15.0 (3.0-223.0) months. The most frequent diagnosis was bronchopulmonary dysplasia (53.5%), followed by bronchiolitis obliterans (14.0%), neurologic disorders (10.5%), cystic fibrosis (8.1%), miscellaneous syndromes (5.8%), sickle-cell disease (3.5%), other neonatal lung diseases (2.3%) and interstitial lung diseases (2.3%). Are maintained on follow-up 53 (61.6%) patients, 38 on oxygen therapy; 12 (13.9%) died. The median time of follow-up was 39.5 (1.0-246.0) months, minim on other neonatal lung diseases and maximum on cystic fibrosis. Comparing with previous review, this shows a relative increase in bronchiolitis obliterans and bronchopulmonary dysplasia patients, with increased duration in the latter, and inclusion of neurologic and hematologic patients.<br /><strong>Discussion:</strong> Prescription of long-term oxygen therapy in pediatric age mainly occurs in specific diseases of infants and pre-school aged. Neurologic and hematologic patients represent new indications, similarly to international publications.<br /><strong>Conclusion:</strong> The knowledge of national reality and pediatric orientations are needed for care plans and rational prescription.<br /><strong>Keywords:</strong> Child; Long-Term Care; Respiratory Insufficiency; Oxygen Inhalation Therapy; Portugal.


Neonatology ◽  
2018 ◽  
pp. 809-822
Author(s):  
Virgilio P. Carnielli ◽  
Paola E. Cogo

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