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

<div><p>Background</p><p>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.</p><p>Methods</p><p>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.</p><p>Results</p><p>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.</p><p>Conclusions</p><p>Ceramides are measurable in TAs of preterm born infants and may be an early marker for BPD development.</p></div

Ceramide patterns in preterm infants with and without bronchopulmonary dysplasia (BPD).

<p>Ceramide patterns (ng/ml) in tracheal aspirates for infants who developed BPD (BPD; ●, continuous line) and infants who did not developed BPD (○, dashed line). Dots represent median values, whiskers 25^th and 75^th percentiles, and group comparison by means of univariate analysis per time point, * = <i>p</i> < 0.01.</p

The change in overall ceramide profile.

<p>The change in overall ceramide profile.</p

Patient characteristics.

<p>Patient characteristics.</p

Flow diagram study population.

<p>Overview of the eligible and included patients between September 2013 and December 2014.</p

Multivariable logistic regression analysis of BPD and respiratory death.

<p>Multivariable logistic regression analysis of BPD and respiratory death.</p