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An update on bronchopulmonary dysplasia: is there a relationship to the development of childhood asthma?
1Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa. js7@sun.ac.za
Insights
Asthma and bronchopulmonary dysplasia (BPD) share rising prevalence, familial clustering, and airway inflammation. Researchers question if BPD represents a distinct asthma phenotype due to these similarities.
Area of Science:
- Pulmonology
- Pediatric Respiratory Medicine
- Immunology
Background:
- Asthma and bronchopulmonary dysplasia (BPD) are increasing in prevalence globally.
- Both conditions exhibit familial clustering and share common clinical and pathological features.
Purpose of the Study:
- To investigate the potential overlap and shared characteristics between asthma and BPD.
- To explore whether BPD could be considered a phenotypic variant of asthma.
Main Methods:
- Comparative analysis of epidemiological data for asthma and BPD.
- Review of shared phenotypes, including wheezing and reversible airway obstruction.
- Examination of inflammatory mediators, anti-inflammatory activity, and airway remodeling in both conditions.
Main Results:
- Asthma and BPD show similar trends in prevalence and familial aggregation.
- Shared phenotypes include wheezing, reversible airway obstruction, and response to pharmacological challenges.
- Both conditions present with elevated airway inflammatory mediators, reduced anti-inflammatory activity, and histological evidence of airway remodeling.
Conclusions:
- Significant commonalities exist between asthma and BPD, particularly in airway inflammation and remodeling.
- The shared characteristics suggest that BPD may represent a distinct phenotypic expression of asthma in susceptible individuals.
Abstract:
There appears to be some interesting commonalities between asthma and BPD. The prevalence of both conditions is on the rise, both conditions tend to cluster in families, and they share wheezing phenotypes, i.e., mild-moderate reversible airway obstruction and a similar degree of response to pharmacological provocation. Furthermore, significant overlap exists with regard to the presence of elevated concentrations of airway inflammatory mediators concurrent with reduced levels of anti-inflammatory activity, in serum and BAL fluid, as well as histological evidence for airway 'remodelling'. Both BPD and asthma are characterized by increased smooth muscle contraction, and in asthma, the smooth muscle may be involved in the primary development of the asthmatic phenotype. Since wheezing is a common finding among children with BPD, an interesting question is whether BPD is a phenotypic variant of asthma?
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