Ceramides in tracheal aspirates of preterm infants: Marker for bronchopulmonary dysplasia

Background
In an experimental mouse model we showed that ceramides play a role in the pathogenesis of bronchopulmonary dysplasia (BPD) and are a potential target for therapeutic intervention. We investigated whether ceramides are detectable in tracheal aspirates (TAs) of preterm infants and differ between infants with or without BPD.
Methods
Infants born ≤ 32 weeks of gestational age in need of mechanical ventilation in the first week of life were included. TAs were obtained directly after intubation and at day 1, 3, 5, 7, and 14. Ceramide concentrations were measured by tandem mass spectrometry. At 36 weeks postmenstrual age BPD was defined as having had ≥ 28 days supplemental oxygen.
Results
122 infants were included, of which 14 died and 41 developed BPD. All infants showed an increase in ceramides after the first day of intubation. The ceramide profile differed significantly between preterm infants who did and did not develop BPD. However, the ceramide profile had no additional predictive value for BPD development over GA at birth, birth weight and total days of mechanical ventilation.
Conclusions
Ceramides are measurable in TAs of preterm born infants and may be an early marker for BPD development.

背景
在实验小鼠模型中，我们证实了神经酰胺（Ceramides）在支气管肺发育不良（bronchopulmonary dysplasia, BPD）的发病机制中发挥作用，且是治疗干预的潜在靶点。本研究旨在探究神经酰胺是否可在早产儿的气管吸出物（tracheal aspirates, TAs）中被检测到，以及合并与未合并BPD的婴儿之间是否存在差异。

方法
纳入出生胎龄≤32周、出生后第一周需接受机械通气的早产儿。分别于气管插管即刻及第1、3、5、7、14天采集气管吸出物样本。采用串联质谱法检测神经酰胺浓度。以校正胎龄36周时需接受≥28天供氧作为BPD的诊断标准。

结果
本研究共纳入122例早产儿，其中14例死亡，41例发生BPD。所有患儿在气管插管后的第一日后，神经酰胺水平均出现升高。发生与未发生BPD的早产儿之间，神经酰胺谱存在显著差异。然而，相较于出生胎龄、出生体重及机械通气总时长，神经酰胺谱对BPD发生的预测并无额外价值。

结论
神经酰胺可在早产儿的气管吸出物中被检测到，或可作为BPD发生的早期标志物。