NIH Grant to Investigate Lung Disease in Premature Babies

May. 10, 2010
A newborn infant in a hospital nursery.

Every year, at least 55,000 premature babies are born with underdeveloped lungs. And while these babies with chronic lung disease are generally treated with success in neonatal intensive care units (NICUs) and the vast majority of them are released when they’re able to breathe on their own, their lung-related issues often don’t end when they leave the hospital.

“On average, premature babies treated in the NICU can visit the doctor’s office up to 20 times within their first year of life, largely because of respiratory symptoms” said Gloria Pryhuber, M.D., associate professor of Pediatrics, Neonatology and Environmental Medicine at Golisano Children’s Hospital at the University of Rochester Medical Center (URMC).

Thanks to a grant from the National Institutes for Health (NIH), Pryhuber and co-investigators, Thomas Mariani, Ph.D., associate professor of Pediatrics and Neonatology at URMC, and Rita Ryan, M.D., associate professor of Pediatrics at the University at Buffalo (UB), will team up as one of six research centers to examine the link between premature birth and later breathing problems in approximately 800 prematurely born infants. Over the course of the next five years, NIH will award the URMC/UB collaborative research center $2.4 million in direct and indirect costs to identify markers and mechanisms for lung-related illnesses that may affect prematurely born babies for years.

Over the course of five years, the team will benchmark cases of bronchopulmonary dysplasia (BPD) among premature babies at birth and one year after birth. Investigators in Rochester and Buffalo will look at the babies’ immune systems to see whether premature babies born with underdeveloped lungs have an abnormally developed immune system as well, which might make it harder to fight off viral infections and could cause toxic damage to the lung’s cells. The local investigators will also contribute to multicenter studies looking for associations between types of infant gut flora, lung and salivary gland secretions and the risk of recurrent breathing problems.

Previous studies suggest that premature babies are more likely to develop long-term breathing issues later in life. Finding out more about possible changes in babies’ immune cells due to premature birth could help providers to know which babies are at increased risk, to understand why they are at risk and to implement plans for preventive follow-up care as the children grow.

Investigators also hope to stratify cases of BPD into different, more specific categories. Babies diagnosed with BPD may have the same symptoms, but a spectrum of diseases. Looking into the detailed make-up of babies’ immune cells may make it easier to provide differentiated treatment for babies with lung-related issues as they grow older.

The study will analyze immune cells from at least 200 infants born as early as 24-weeks of gestation by using state-of-the-art technology, working closely with the Flow Cytometry Core and the Human Immunology Center at the University of Rochester. Investigators will examine the cells just after the babies are born in detail, near the time of discharge from the NICU and again at one year of age.

Researchers in the centers will conduct genome-wide expression analysis of sorted subclasses of immune cells. This will allow them to look at the repertoire of cells and determine whether populations of individual cell types are associated with changes in the immune function that could lead to an increased risk of infections and breathing symptoms. By analyzing patterns of gene expression, investigators can also examine changes in the ways subpopulations of cells respond to stimuli, to better understand how various factors from premature birth can affect the immune system.

The six clinical research centers include investigators from URMC and University at Buffalo (as co-collaborators for one center), Vanderbilt University, Washington University in St. Louis, University of California in San Francisco and Cincinnati Children’s Hospital. The University of Pennsylvania will be the data management center.