Tracheal aspirate VEGF and sphingolipid metabolites in the preterm infant with later development of bronchopulmonary dysplasia

Objective: Vascular endothelial growth factor (VEGF) and sphingolipid metabolites, sphingosine 1-phosphate (S1P), and ceramides are important to lung development and repair. We hypothesized specific sphingolipid and VEGF alterations would be associated with BPD development and aimed to investigate the early tracheal aspirate (TA) VEGF and S1P relationship with later diagnosis of preterm infant bronchopulmonary dysplasia, BPD.

Design: TA VEGF and lipidomics were measured in TA from Infants <32 weeks gestational age at birth with and without later BPD. BPD was defined using the NICHD severity BPD definition. Clinical demographics and medical course were identified with statistical analysis performed with JMP, Statistical Analysis Software.

Results: The analysis included 25 infants (9 NoBPD and 16 BPD) with mean gestational age of 27.8 ± 2.5 SD weeks and 25.1 ± 1.9 SD weeks respectively, P < 0.01. Later development of BPD was associated with elevated mean TA VEGF 604.3 ± 150.2 SE pg/mL versus NoBPD 120 ± 34.3 SE pg/mL, elevated S1P, 11.5 ± 2.3 SE pmol/mL versus NoBPD 4.8 ± 0.6 SE pmol/mL, and elevated selected ceramides during the first week of life.

Conclusions: Airway VEGF and sphingolipid metabolites were distinctly elevated within the first days of postnatal life in preterm infants with later BPD progression. These biomarkers may be useful as indicators of lung injury development or as targets to decrease BPD risk.