It is a kind of vicious circle in neonatology, neonatal medicine:
Because the lungs of premature babies are not yet mature enough, the so-called respiratory distress syndrome develops and the babies cannot breathe on their own. The “preemies”, as parents and doctors affectionately call the youngest patients, must therefore be artificially ventilated. The use of oxygen therapy, however, leads to a chronic lung disease, bronchopulmonary dysplasia (BPD). BPD makes children susceptible to other respiratory diseases and limits their lung function. Using the AIRR study data, the team led by Dr. Anne Hilgendorff wants to find out whether and how this "vicious circle" can be broken:
"We want to better understand and make an earlier diagnosis of the lung condition of babies born prematurely, called BPD, so that in the future we can already say in the delivery room: We are now better able to help your child and avoid long-term complications."
PD Dr. Anne Hilgendorff
Detect earlier, treat better
The problem with preterm babies and BPD:
So far, it is only possible to diagnose very late which baby develops the lung disease and which baby does not. There is also a lack of understanding of the molecular mechanisms underlying BPD: What impedes alveolar and capillary development in the lungs of premature infants? And how can we detect these damages as early as possible?
BPD is currently diagnosed shortly before release from the hospital, before the calculated date of birth is reached. A point in time at which many therapeutic opportunities are missed.
One of the aims of the AIRR study: identify biomarkers in order to diagnose this chronic lung disease better and earlier.
BPD on the track - innovative approaches in the search for biomarkers
Lung and lung tissue examinations as performed in various adult diseases are not possible in premature babies. The AIRR study team therefore uses three other modern approaches in its examination methods:
First success - Three proteins signal BPD
To find suitable biomarkers, the team from the AIRR study examined blood plasma samples from preterm infants – once in the first week of life and again on the 28th day of life. The samples were analyzed for changes in certain proteins using a statistical model. The question: Are there proteins that already reveal a threatening BPD immediately after birth? Result: There are exactly three specific proteins that became conspicuous. They were already suspected of contributing to the development of bronchopulmonary dysplasia. Further investigations are now to confirm that these proteins can be used as marker proteins for the early diagnosis of BPD. This would greatly facilitate the early and individually coordinated therapy of premature babies. For example, the ventilation situation could be adjusted more precisely, as well as the intake of fluids or the administration of medications such as cortisone or vitamin A.
PD Dr. med. Anne Hilgendorff
anne.hilgendorff (at) helmholtz-muenchen.de
Comprehensive Pneumology Center (CPC-M)
PD Dr. med. Anne Hilgendorff, Head
Sonja Dull, Study Nurse
Yvonne Wenninger, study coordination
Förster et al., Am J Respir Crit Care Med. 2018:
Reicherzer, T. et al., Am. J. Physiol. Lung Cell Mol. Physiol. , 2018: