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Development and Disorders of the Airway in Bronchopulmonary Dysplasia

Douglas Bush1, Courtney Juliano2, Selina Bowler3

  • 1Division of Pediatric Pulmonology, Department of Pediatrics, Mount Sinai Hospital, Icahn School of Medicine, New York, NY 10029, USA.

Children (Basel, Switzerland)
|July 29, 2023
PubMed

Insights

Bronchopulmonary dysplasia (BPD) in premature infants involves arrested lung development. This study highlights the crucial role of airway pathology in BPD, impacting respiratory health in neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Developmental Biology

Background:

  • Bronchopulmonary dysplasia (BPD) is a major cause of death in premature infants, primarily studied for lung parenchymal changes.
  • The role of airway disease in BPD pathophysiology is less understood, despite immature conducting airways being vulnerable to injury.
  • Neonates with BPD, especially those requiring ventilation, are susceptible to airway pathology, impacting chronic lung disease.

Purpose of the Study:

  • To emphasize the significance of airway disease in the pathophysiology of bronchopulmonary dysplasia (BPD).
  • To explore how immature and developing airways in preterm infants contribute to BPD complications.
  • To investigate the link between airway pathology and increased respiratory morbidity in premature infants with chronic lung disease.

Main Methods:

  • Review of existing literature on BPD and airway development in preterm infants.
  • Analysis of the structural and functional characteristics of immature conducting airways.
  • Correlation of airway pathology with clinical outcomes in neonates requiring positive-pressure ventilation.

Main Results:

  • Immature conducting airways in preterm infants are prone to deformation and damage due to their compliance.
  • Positive-pressure ventilation exacerbates airway injury and disrupts normal airway maturation in neonates.
  • Airway pathology, encompassing both large and small airways, is a significant contributor to respiratory morbidity in BPD.

Conclusions:

  • Airway disease is a critical, understudied component of bronchopulmonary dysplasia (BPD) pathophysiology.
  • Protecting and supporting airway development is essential for improving outcomes in premature infants with BPD.
  • Further research into airway-specific interventions is warranted to reduce respiratory morbidity in neonates with chronic lung disease.

Keywords:
airway developmentairway disordersbronchopulmonary dysplasia

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