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Published on: October 19, 2013
Antioxidants and neonatal lung disease
1Department of Child Health, St Michael's Hospital, Bristol, UK.
Insights
Bronchopulmonary dysplasia (BPD) in premature infants is linked to oxidant stress and low antioxidant levels. Antenatal steroids may help by boosting lung antioxidants and surfactant, offering a potential management strategy.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pulmonary Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a persistent challenge in neonatal intensive care survivors.
- Oxygen toxicity and an imbalance in the oxidant-antioxidant system are implicated in BPD pathogenesis.
- Preterm infants exhibit insufficient antioxidant potential, making them vulnerable to oxidant stress at birth.
Purpose of the Study:
- To explore the role of oxidant-antioxidant imbalance in BPD pathogenesis.
- To investigate potential therapeutic strategies for managing BPD in preterm infants.
Main Methods:
- Review of existing literature on BPD, oxygen toxicity, and antioxidant mechanisms.
- Analysis of the biochemical challenges in preterm neonates regarding oxidant stress.
- Examination of the effects of antenatal steroid therapy on pulmonary antioxidants and surfactant.
Main Results:
- Preterm infants are susceptible to significant oxidant stress due to inadequate antioxidant defenses.
- Antenatal steroid administration has demonstrated potential in augmenting pulmonary antioxidants and surfactant production.
- Exogenous antioxidant enzyme administration (e.g., superoxide dismutase, catalase) shows promise in animal models.
Conclusions:
- Addressing the oxidant-antioxidant imbalance is crucial for managing preterm infants at risk for BPD.
- Antenatal steroid therapy presents a promising approach to ameliorate this imbalance.
- Further clinical research is needed to evaluate the efficacy of exogenous antioxidant therapies in humans.
Abstract:
Bronchopulmonary dysplasia (BPD) remains a clinical problem in survivors of neonatal intensive care despite recent advances which include surfactant replacement. Oxygen toxicity may well be a component in the pathogenesis of BPD and disturbance of the oxidant-antioxidant balance constitutes a biochemical problem which should be addressed in the management of preterm babies. Preterm babies appear to have inadequate antioxidant potential and yet when delivered may experience considerable oxidant stress. This imbalance may be ameliorated by antenatal steroid therapy which augments pulmonary antioxidants as well as surfactant production. Augmentation of antioxidants by administration of exogenous enzymes such as superoxide dismutase and catalase is possible in animal models but the clinical use of such therapies awaits further research.
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