Pathogenesis and prevention of acute and chronic lung disease in newborn infants

With the introduction of new treatment modalities, more critically ill infants are surviving the neonatal period and developing acute and chronic lung injury such as Bronchopulmonary Dysplasia (BPD). The development of BPD is associated with significant morbidity and mortality. BPD is hypothesized to begin as acute inflammatory changes in the lung secondary to a variety of prenatal/postnatal insults including toxic reactive oxygen species (ROS), which then evolve into chronic lung disease. The premature neonate may be particularly vulnerable to oxidant injury, since endogenous antioxidant enzyme activity may be deficient at birth. A logical strategy to prevent oxidant-induced lung injury is supplementation with antioxidant enzymes (AOE). This chapter will focus on the basic science and clinical studies involved in the development of antioxidant strategies to prevent BPD in newborns and Acute Respiratory Distress Syndrome (ARDS) -related injuries in adults.