Unique Patterns of Circulating Extracellular Vesicles in Preterm Infants During Adaptation to Extra-Uterine Life

Area of Science:

• Neonatal pathology
• Extracellular vesicle (EV) research
• Perinatal adaptation

Background:

• Extracellular vesicles (EVs) play a role in neonatal pathology.
• Characterizing circulating EVs in preterm infants is crucial for understanding perinatal adaptation.

Purpose of the Study:

• To characterize circulating EVs in preterm infants during perinatal adaptation.
• To differentiate EV changes related to prematurity versus normal adaptation to extrauterine life.

Main Methods:

• Single-centre prospective observational study.
• Analysis of cord and postnatal plasma from preterm and term infants.
• Utilized nanoparticle tracking analysis, flow cytometry, proteomics, and procoagulant activity assays.

Main Results:

• Preterm infants showed significant changes in EV concentration, size, cellular origin, and proteomic content.
• A dramatic increase in small and large EVs was observed on Day 3 in preterm infants.
• Elevated platelet, endothelial, and tissue factor EVs were noted, with differential protein expression related to hemostasis, pulmonary physiology, and immunity.

Conclusions:

• Circulating EV profiles in preterm infants differ markedly from healthy term infants.
• Findings highlight the importance of sample collection timing in neonatal EV studies.
• Further research is needed to determine the clinical implications of these unique EV profiles.