“新型”支气管肺发育不良生物标志物的研究现状

Current research status on biomarkers of "new" bronchopulmonary dysplasia

支气管肺发育不良(BPD)是影响早产儿存活率及生存质量的肺部严重并发症,早期诊断BPD在提高此类早产儿存活率及避免肺重构方面起着重要作用。因此,寻找早期诊断BPD的生物标志物,一直是该领域的研究热点。但是,目前对BPD生物标志物的研究,大多从经典型BPD病理生理角度,即肺部感染及炎症、肺纤维化与氧化应激等进行研究,很少从“新型”BPD的肺泡发育阻滞、肺微循环障碍角度,研究BPD的生物标志物。最新研究结果显示,肺泡发育相关生物标志物,如Ⅱ型肺泡细胞表面抗原(KL-6)、血清Clara细胞分泌蛋白(CC16),以及肺微血管发育相关的血管内皮生长因子(VEGF)、血管生成素(Ang)、内皮抑制素(ES),均与早产儿BPD的发生具有一定关系,或许可能成为早期预测“新型”BPD发生的生物标志物。此外,组学相关生物标志物在BPD的研究中,也越来越受到重视。因此,笔者拟从肺泡发育、肺微血管生成及组学3个方面,对“新型”BPD生物标志物的最新研究进展进行阐述,从而尽可能指导临床应用这些生物标志物,早期识别、早期干预可能发生BPD的高危早产儿,旨在尽可能减少早产儿BPD的发生,改善此类早产儿的临床预后,提高其生命质量。

Bronchopulmonary dysplasia(BPD)is a serious pulmonary complication that affects the survival rate and quality of premature infants.Early diagnosis of BPD is critical to improve the survival rate and prevent chronic lung remodeling of premature infants.So finding appropriate biomarkers for early diagnosis of BPD has always been the focuses of this field.But the recent studies of BPD biomarkers are mostly focused on the perspective of lung inflammation and infection,lung fibrosis and oxidative stress,which are the pathological physiological characteristics of typical BPD,rarely in terms of pulmonary alveoli development block and pulmonary microcirculation disturbance of lung,which are typical characteristics of pathological physiological of"new"BPD.Recent studies have shown that there may be some relationship between"new"BPD and pulmonary alveoli related biomarkers of Krebs Von den lungen-6(KL-6)and Clara cell secretory protein(CC16),and pulmonary microvascular related biomarkers of vascular endothelial growth factor(VEGF),angiopoietin(Ang)and endostatin(ES),which may probably be the appropriate biomarkers to predict the development of"new"BPD.In addition,the omics related biomarkers of BPD have received more and more attentions in recent years.So,in this article,the authors will review the recent research advances of biomarkers of"new"BPD in terms of pulmonary alveoli development,pulmonary micro-angiogenesis and omics,which may contribute to early prevention and treatment of BPD and improve prognosis and life quality of these premature infants.