The Cytokines, Exhaled Nitric Oxide are Risk Factors in Preterm Infants for Bronchopulmonary Dysplasia

Background Bronchopulmonary dysplasia (BPD) remains the most frequently complication of extreme preterm infants. Multiple clinical factors and inflammatory markers have all been associated with BPD. Therefore, this study targeted to detect cytokines and fractional exhaled nitric oxide(FeNO) to evaluate their mechanism and possible predicted significance for BPD. Methods Preterm infants born at gestational age ≤ 32 weeks were recruited between January 2018 and October 2019. The clinical data of infant characteristics and maternal characteristics were collected. Our study detected a total of ten cytokines include IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8 and TNF-α on day 1–3, day 7–14, and day 21–28 after birth via Meso Scale Discovery (MSD) technology. FeNO levels were measured when the infants met discharge criteria. Results A total of 46 preterm infants were enrolled in this study, including 14 infants in BPD group and 32 infants in control group. The gestational age 【(27.5 ± 1.3) vs. (29.9 ± 1.3) weeks】and birth weight【(1021 ± 261)g vs. (1489 ± 357)g】of BPD group were lower than those of control group. Multivariate logistic regression analysis showed that gestational age < 30 weeks, birth weight < 1000 g, PDA, longer mechanical ventilation and invasive ventilation duration were high risk factors for BPD. The cytokines of IL-6, IL-8 on day 7–14 and IL-4, IL-6, IL-8, TNF-α on day 21–28 were also the high risk factors for BPD. Other risk factors for BPD included elevated Eosnophils on day 21–28 and FeNO. Conclusion The preterm infants with PDA, prolonged mechanical ventilation tended to develop BPD. The FeNO, Eosnophils, cytokines such as IL-4, IL-6, IL-8, TNF-α were high risk factors for BPD. Our study speculate that NO was related to BPD though Th2-cell-mediatedinflammatory responses such as IL-4. The cytokines may provide a certain predictive value for the occurrence of BPD.