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Updated: Jun 8, 2025

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Published on: May 4, 2020
Endoplasmic Reticulum Stress in Bronchopulmonary Dysplasia: Contributor or Consequence?
Tzong-Jin Wu1,2, Michelle Teng1,2, Xigang Jing1,2
1Department of Pediatrics, Medical College of Wisconsin, Suite C410, Children Corporate Center, 999N 92nd Street, Milwaukee, WI 53226, USA.
Insights
Endoplasmic reticulum (ER) stress contributes to bronchopulmonary dysplasia (BPD) in premature infants. Chemical chaperones and N-acetyl-lysyltyrosylcysteine amide (KYC) show promise in mitigating ER stress and BPD progression.
Area of Science:
- Neonatal Medicine
- Cellular Biology
- Pharmacology
Background:
- Bronchopulmonary dysplasia (BPD) is a major complication of prematurity, driven by oxidative stress and inflammation.
- Endoplasmic reticulum (ER) stress, triggered by oxidative stress, impairs cellular functions vital for lung development, including protein synthesis and metabolic homeostasis.
- ER stress contributes to BPD pathogenesis, leading to cellular senescence and impaired organ growth.
Purpose of the Study:
- To review the role of ER stress in the development of BPD.
- To discuss the therapeutic potential of chemical chaperones and N-acetyl-lysyltyrosylcysteine amide (KYC) in managing BPD.
Main Methods:
- Literature review focusing on the mechanisms of ER stress in BPD.
- Analysis of studies investigating chemical chaperones and KYC as therapeutic agents.
- Examination of evidence linking ER stress to cellular senescence in the context of BPD.
Main Results:
- ER stress is a key factor in BPD development, as demonstrated by animal models.
- Chemical chaperones can attenuate BPD but do not fully resolve ER stress-induced senescence.
- N-acetyl-lysyltyrosylcysteine amide (KYC), a myeloperoxidase inhibitor, effectively reduces ER stress and cellular senescence.
Conclusions:
- ER stress is a significant contributor to BPD pathogenesis.
- Chemical chaperones offer partial therapeutic benefits for BPD.
- KYC presents a promising therapeutic strategy for BPD by targeting ER stress and senescence.
Abstract:
Bronchopulmonary dysplasia (BPD) is the most common complication of prematurity. Oxidative stress (OS) and inflammation are the major contributors to BPD. Despite aggressive treatments, BPD prevalence remains unchanged, which underscores the urgent need to explore more potential therapies. The endoplasmic reticulum (ER) plays crucial roles in surfactant and protein synthesis, assisting mitochondrial function, and maintaining metabolic homeostasis. Under OS, disturbed metabolism and protein folding transform the ER structure to refold proteins and help degrade non-essential proteins to resume cell homeostasis. When OS becomes excessive, the endogenous chaperone will leave the three ER stress sensors to allow subsequent changes, including cell death and senescence, impairing the growth potential of organs. The contributing role of ER stress in BPD is confirmed by reproducing the BPD phenotype in rat pups by ER stress inducers. Although chemical chaperones attenuate BPD, ER stress is still associated with cellular senescence. N-acetyl-lysyltyrosylcysteine amide (KYC) is a myeloperoxidase inhibitor that attenuates ER stress and senescence as a systems pharmacology agent. In this review, we describe the role of ER stress in BPD and discuss the therapeutic potentials of chemical chaperones and KYC, highlighting their promising role in future therapeutic interventions.
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