Abstract
Background: Platelets play an important role in the formation of pulmonary blood vessels, and thrombocytopenia is common in patients with pulmonary diseases. However, a few studies have reported on the role of platelets in bronchopulmonary dysplasia.Objective: The objective of the study was to explore the relationship between platelet metabolism and bronchopulmonary dysplasia in premature infants.Methods: A prospective case-control study was performed in a cohort of premature infants (born with a gestational age <32 weeks and a birth weight <1,500 g) from June 1, 2017 to June 1, 2018. Subjects were stratified into two groups according to the diagnostic of bronchopulmonary dysplasia: with bronchopulmonary dysplasia (BPD group) and without bronchopulmonary dysplasia (control group). Platelet count, circulating megakaryocyte count (MK), platelet-activating markers (CD62P and CD63), and thrombopoietin (TPO) were recorded and compared in two groups 28 days after birth; then serial thrombopoietin levels and concomitant platelet counts were measured in infants with BPD.Results: A total of 252 premature infants were included in this study. Forty-eight premature infants developed BPD, 48 premature infants without BPD in the control group who were matched against the study infants for gestational age, birth weight, and admission diagnosis at the age of postnatal day 28. Compared with the controls, infants with BPD had significantly lower peripheral platelet count [BPD vs. controls: 180.3 (24.2) × 109/L vs. 345.6 (28.5) × 109/L, p = 0.001]. Circulating MK count in the BPD group was significantly more abundant than that in the control group [BPD vs. controls: 30.7 (4.5)/ml vs. 13.3 (2.6)/ml, p = 0.025]. The level of CD62p, CD63, and TPO in BPD group was significantly higher than the control group [29.7 (3.1%) vs. 14.5 (2.5%), 15.4 (2.0%) vs. 5.8 (1.7%), 301.4 (25.9) pg/ml vs. 120.4 (14.2) pg/ml, all p < 0.05]. Furthermore, the concentration of TPO was negatively correlated with platelet count in BPD group with thrombocytopenia.Conclusions: Our findings suggest that platelet metabolism is involved in the development of BPD in preterm infants. The possible mechanism might be through increased platelet activation and promoted TPO production by feedback.
Highlights
Bronchopulmonary dysplasia (BPD) is one of the common complications in neonatal intensive care units (NICU) and is considered to be the main cause of death in preterm infants [1]
Alveolar and microvascular arrest is considered as the pathological feature of clinical bronchopulmonary dysplasia [5], the development of alveolar microvascular can promote the formation of alveoli structure; the role of pulmonary vascular development, especially in pulmonary microvascular development in BPD is getting more and more attention
We evaluated this hypothesis by comparing peripheral platelet count, circulating MK count, platelet-activating markers, (CD62P and CD63) 28 days after birth in two groups, and the relationship between TPO expression and platelet count in infants with BPD
Summary
Bronchopulmonary dysplasia (BPD) is one of the common complications in neonatal intensive care units (NICU) and is considered to be the main cause of death in preterm infants [1]. The platelet plays an essential role in the formation and development of pulmonary blood vessels, as demonstrated by numerous studies [6, 7]. Some clinical retrospective studies [8, 9] found that mean platelet volume might predict the occurrence of BPD, and a study [10] has shown that higher platelet count is an independent factor of the development of moderate–severe BPD, and the research [11] found that a higher platelet transfusion threshold can increase the risk of BPD in premature infants. A few studies have reported on the role of platelets in bronchopulmonary dysplasia
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