| Contents |
Details |
Introduction
(pdf 205 kb) |
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Lung development and inflammation
Alan H. Jobe (pdf 111 kb) |
Professor Jobe opened the symposium with a scene-setting presentation on the physiology of lung development
and the mechanics of inflammation, and highlighted evidence to suggest that antenatal exposure to inflammation
may actually induce lung maturation. |
Surfactants today and tomorrow
Henry L. Hlliday (pdf 73 kb) |
The past and future of surfactant therapy was unravelled by Professor Halliday. A number of well-designed
studies have been conducted in preterm infants; evidence from such trials confirms that surfactant improves
outcomes in these infants, particularly when used in conjunction with CPAP. While similar efficacy outcomes
have been demonstrated for the available surfactants, current cost-effectiveness data indicate that cost savings
are associated with the use of the animal-derived surfactant Curosurf® (poractant alfa). |
Long-term respiratory outcome following preterm delivery
Janet Stocks
(pdf 130 kb)
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The availability of surfactant treatment, in addition to other interventions, has meant that VLBW infants now have a greater chance of survival, albeit at the expense of increased pulmonary sequelae. Professor Stocks discussed the long-term respiratory outcomes in preterm infants, and presents available data on lung function as these infants progress into child and adulthood. While the consequences of preterm birth may be reduced over time, they are likely to persist in some individuals. It is clear that improved survival of preterm neonates will enable a greater understanding of the long-term impact of early lung insults.
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A new approach to acceleration of fetal lung maturation by pioglitazone
Florian Guthmann (pdf 77 kb)
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Dr Guthmann highlighted the potential for the PPAR agonist pioglitazone as an alternative to glucocorticoid treatment. Preclinical data indicate that pioglitazone displays a 'healing' effect and increases the expression of various proteins, including the expression of ABCA3.
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Lung function in heterozygote carriers of ABCA3 mutations
Olivier Danhaive
(pdf 131 kb)
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The contributions of ABCA3 mutations to pulmonary surfactant deficiency were explored by Dr Danhaive who
investigated the phenotypes associated with these mutations in three pedigrees involving infants with RDS and their first-degree relatives.
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Human pulmonary nitric oxide synthases (NOS) and nitrotyrosine: Findings during neonatal development and in chronic lung disease (CLD)
Mark J.Sheffield
(pdf 90 kb)
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The contribution of NO to many biochemical interactions is undisputed. It therefore comes as no surprise that NOS isoforms are present in the lung - even in VLBW infants. Professor Sheffield presented data from the most complete human study on the developmental expression of NOS isoforms. It appears on the basis of current evidence it may not always be beneficial to administer exogenous NO in preterm infants.
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The impact of prenatal and postnatal steroids and surfactant replacement therapy on the outcome of preterm infants
Eric S. Shinwell
(pdf 112 kb)
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Professor Shinwell provides an insight into the use of prenatal and postnatal steroids in current clinical practice. A full course of corticosteroids has been associated with beneficial effects in multiple pregnancies, including the prevention of RDS and brain haemorrhage. However, evidence indicates that these agents may be associated with adverse neurological outcomes when administered pre- or postnatally
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Question and answer session
(pdf 38 kb)
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