Lifelong Health Research Articles

Sexspan: a comprehensive framework for sustaining lifelong sexual health and vitality

Sexspan: a comprehensive framework for sustaining lifelong sexual health and vitality

Advancing Youth Peer Advocacy and Support Services: Responding to NASEM Consensus Report on Launching Lifelong Health by Improving Health Care for Children, Youth, and Families (2024).

Advancing Youth Peer Advocacy and Support Services: Responding to NASEM Consensus Report on Launching Lifelong Health by Improving Health Care for Children, Youth, and Families (2024).

A staged integrated model informing the promotion of healthy dietary behaviors in adolescents: a prospective study

BackgroundThe promotion of healthy dietary behaviors in adolescence is critical, which have long-term implications for lifelong health. Integration is an important method for improving limited theories of dietary behavior change. The present study proposes an integrated model aimed at identifying the diverse determinants of healthy dietary behaviors in adolescents and assesses its stage-specific nature as the potential for effective interventions.MethodsA two-year prospective study was conducted in southwest China, involving a sample of 1990 adolescents (mean age: 15.06 years) from two randomly selected secondary schools. A total of 765 adolescents were exposed to the three-phase interventions while 1225 adolescents participated as the control group. The interventions aimed to promote healthy dietary behaviors in adolescents, which included health education sessions and health handbooks targeting specific constructs of the integrated model. The follow-up surveys after corresponding interventions were performed every six months. Self-reported frequency of healthy dietary behaviors, psychological constructs integrated from Health Action Process Approach, Health Belief Model, and Theory of Planned Behavior, as well as anxiety symptoms were measured.ResultsWithin structural equation modeling controlling for past behavior, the integrated model accounted for 61.7% variance of behavioral intentions and 19.1% variance of healthy dietary behaviors, and showed discontinuity patterns across behavior change phases. The pivotal constructs included outcome expectancies, perceived severity, subjective norms, action self-efficacy, behavioral intentions, action planning, and maintenance self-efficacy. Anxiety was an emotional barrier in the dietary behavior modification (β = -0.113, P < .001). Interventions within the staged integrated model, led to increased adoption of healthy dietary behaviors in intervention group compared to control group (33.40% vs. 25.70%, P < .05), indicating certain effectiveness, particularly in targeting action self-efficacy (stronger direct effects on behavioral intentions and maintenance self-efficacy, β = 0.489 to 0.704, P < .001).ConclusionsThe staged integrated model provides a detailed understanding of the determinants of healthy dietary behaviors in adolescence, highlighting anxiety as an emotional barrier that impedes positive cognition and healthy dietary behaviors. It provides valuable guidance for future interventions targeting specific constructs across behavior change phases, with particular emphasis on enhancing action self-efficacy.

Quantifying the Diagnostic Odyssey Burden Among Persons with Inborn Errors of Immunity

PurposePatients with inborn errors of immunity (IEI) have lifelong health complications including severe infections and physical impairments. Previous studies show that a patient’s perception of their health is an important predictor of health outcomes. The purpose of this study was to understand factors related to patient reported health status.MethodsWe used data from the Immune Deficiency Foundation (IDF) 2017 National Patient Survey and analyzed factors which correlated with the reported health status (RHS). Among a cohort of 1139 self-reported IEI patients, we identified age at the time of diagnosis, time gap between symptom onset and diagnosis, number of physicians seen, and whether the diagnosis was made in the first 5 years of life as significant. We used a two-tailed t-test, single-factor ANOVA, and Tukey-Kramer post-hoc test to assess statistical significance in the observed difference.ResultsPatients who received a diagnosis before the age of 12 had a significantly better mean RHS (n = 207 pre-12a vs. n = 900 post-12a; p < 0.0001). Patients who received a diagnosis within 10 years of symptom onset showed improved mean RHS (n = 413 pre-10 vs. n = 524 post-10; p < 0.0001). Among patients who had symptom onset within the first 5 years of life, those who received a diagnosis had a significantly improved RHS (3.5 ± 0.92, n = 275 undiagnosed vs. 2.8 ± 0.94, n = 108 diagnosed; p < 0.0001). Finally, RHS was significantly impacted by number of physicians(n ≥ 4) seen prior to diagnosis (3.1 ± 0.96 vs. 3.4 ± 0.80, p < 0.0001).ConclusionThese findings shed light upon critical factors which impact IEI patient RHS. Specifically, we find that efficient, rapid and early-life IEI identification should improve patient reported health and relevant outcomes. These improvements appear to be independent of the clinician specialty ultimately making the IEI diagnosis.

Timing of exposure to household poverty and adolescent mental health problems

AimsMental health problems in adolescence are increasingly prevalent and have tremendous impacts on life-long health and mortality. Although household poverty is a known risk factor for adolescent mental health, evidence of the timing hypothesis is scarce. We aimed to examine the longitudinal associations of poverty across childhood with mental health in adolescence, focusing on the timing of exposure.MethodsWe used the data of 5,671 children from a Japanese population-based longitudinal cohort, which recruited the first graders (aged 6–7 years) and followed biannually until eighth grade (aged 13–14 years) in Adachi, Tokyo. Household poverty was defined as households having any of the following experiences: annual income less than Japanese yen 3 million, payment difficulties and material deprivations, measured in first, second, fourth, sixth and eighth grades. Adolescent mental health included parent-report internalizing and externalizing problems (the Strengths and Difficulties Questionnaire), self-report depression (the Patient Health Questionnaire-9) and self-esteem (the Japanese version Children’s Perceived Competence Scale) in eighth grade. We applied g-estimation of structural nested mean modelling to account for time-varying confounders.ResultsIf adolescents were exposed to household poverty at any grade across childhood, on average, they would report more severe depressive symptoms (ψ = 0.32 [95% CI 0.13; 0.51]) and lower self-esteem (ψ = −0.41 [−0.62; −0.21]) in eighth grade. There were also average associations of household poverty at any grade with more internalizing (ψ = 0.19 [0.10; 0.29]) and externalizing problems (ψ = 0.10 [0.002; 0.19]). Although the associations between household poverty and mental health were stronger in younger ages (e.g., poverty in the second grade → depression: ψ = 0.54 [−0.12; 1.19] vs. poverty in the eighth grade → depression: ψ = −0.01 [−0.66; 0.64]), overlapping 95% CIs indicated no statistically significantly different associations by the timing of exposure.ConclusionWe found the average effect of exposure to household poverty at any grade on mental health outcomes in eighth grade, failing to support the timing hypothesis. The findings indicate that the effects of household poverty accumulate over time in childhood and impact adolescent mental health (cumulative hypothesis) rather than the effects differ by the timing of exposure. While cumulative effects suggest a persistent intervention in poor households across childhood, we highlight intervention at any timing in childhood may be effective in alleviating adolescent mental health problems.

Oxidative Stress in Children and Adolescents: Insights Into Human Biology.

Oxidative stress (OS) is a key biological challenge and selective pressure for organisms with aerobic metabolism. The result of the imbalance between reactive oxygen species production and antioxidant defense, OS can damage proteins, lipids, and nucleic acids and plays an important role in driving variation in biological aging and health. Among humans, OS research has focused overwhelmingly on adults, with demonstrated connections between OS, inflammation, and metabolic and neurodegenerative conditions. Relatively little attention has been given to OS during childhood and adolescence. This lack of early life OS research exists despite clear implications for informing human life history evolution, subadult development, and lifelong health. Here, we review current knowledge on OS during human subadulthood. Our objectives are threefold: (1) To highlight common methods for measuring OS among children and adolescents and to establish typical measurement values; (2) To summarize the evidence linking demographic and ecological factors to variation in subadult OS; (3) To identify avenues for future OS research in human biology. Our review underscores an expanding methodological toolkit for assessing OS among children and adolescents. Subadult OS is considerably elevated compared to OS among adults, a pattern eliciting unknown consequences and likely related to increased early life metabolic demands (e.g., unique human brain development). Factors such as diet, physical activity, infectious disease, and structural neglect also appear to drive subadult OS. Current limitations for research on subadult OS are evident. Future work should emphasize evolutionary, biocultural, and energetic life course perspectives to advance this promising area of human biology.

Childhood Environmental Unpredictability and Adolescent Mental Health and Behavioral Problems

ABSTRACTChildhood adversity takes a toll on lifelong health. However, investigations of unpredictability as a form of adversity are lacking. Environmental unpredictability across multiple developmental periods and ecological levels was examined using a multiethnic, longitudinal birth cohort (1998–2000) oversampled for unmarried parents. Data were from the Future of Families and Child Wellbeing Study (N = 4898 youth at birth; 52% male; 48% Black, 27% Hispanic, 21% White) to examine unpredictability at ages 1, 3, 5, and 9 with later adolescent outcomes. An unpredictability index was associated with age 15 outcomes (N = 3595) including depressive symptoms (β = 0.11), anxiety symptoms (β = 0.08), delinquency (β = 0.13), impulsivity (β = 0.09), heavier weight categories (β = 0.09), and internalizing (β = 0.14), externalizing (β = 0.23), and attention problems (β = 0.16). Findings support unpredictability as a unique form of adversity.

Tooth Shame - An Ethnographic Study of the Choreographies of Tooth Shame in Danish Elderly Care (SSM-D-24-02581)

This study suggests the term tooth shame and explores it as a phenomenon encompassing deep entanglements between emotional experiences, social interactions, and care work practices. Drawing on shame research concerning the body, health, and class, juxtaposed with odontological research on the social implications of oral health issues, it investigates how tooth shame appears in Danish elderly care. In Denmark, oral health is notably impaired among older people depending on professional care, with significant repercussions for general health and social life. The study stems from the Lifelong Oral Health project, which identifies barriers to oral health and examines the potential to improve it in Danish elderly care. It is based on ethnographic fieldwork in nursing homes, home care units, and a rehabilitation center in two Danish municipalities. As self-derogative statements and self-limiting behaviors regarding oral health issues stood out as a general finding in interviews with older people, the focus on tooth shame emerged from this fieldwork. The study contributes to recent shame discussions with a social-material understanding of tooth shame, emphasizing that it is more than an individual feature. It is a collectively distributed phenomenon that expands among people and situations, and that interferes with vital caring practices. The study suggests that tooth shame appears through the performance of tooth shame choreographies, highlighting its implications in a socio-material setting. First, it demonstrates that tooth shame can make older people adapt to oral health issues, for example, by avoiding social interactions, dental care, and oral treatments. Second, it identifies tooth shame as a collectively distributed and expanding phenomenon, as it draws, for example, care workers into sensitive shame situations. Third, it explores how tooth shame interferes with daily dental care practices, professional considerations, and ethical dilemmas within elderly care systems.

A Comprehensive Review of the Impact of Medications in Family Medicine on the Health of Pregnant Women and Children: Risks and Benefits

The impact of medications on the health of pregnant women and their children is a critical area of concern in medical research and obstetrics. During pregnancy, women often require treatment for various health conditions, including chronic illnesses like diabetes, hypertension, and mental health disorders. However, the use of medications during this sensitive period can pose risks, as some drugs may cross the placental barrier and affect fetal development. Certain medications have been associated with adverse outcomes, including congenital malformations, preterm birth, and low birth weight. The balance between effectively managing maternal health and minimizing potential harm to the fetus necessitates careful consideration and consultation between healthcare providers and expecting mothers. Children&amp;apos;s health can also be significantly impacted by maternal medication use during pregnancy, with possible long-term consequences. Research indicates that in utero exposure to specific medications may increase the risk of developmental delays, behavioral issues, and lifelong health concerns. For example, the use of antiepileptic drugs or antidepressants during pregnancy has been linked to neurodevelopmental disorders in offspring. It is essential for healthcare providers to closely monitor and assess the risk-benefit ratio of medications prescribed to pregnant women, emphasizing the importance of individualized treatment plans and informed decision-making. Moreover, adequate education on the safe use of medications during pregnancy can help mitigate risks and ensure healthier outcomes for both mothers and their children.

A Qualitative Study of Primary Care Physicians' Approaches to Caring for Adult Adopted Patients.

Adoption has lifelong health implications for 7.8 million adopted people and their families in the United States. The majority of adoptees have limited family medical history (LFMH). Primary care physicians (PCPs) rarely receive training about adoptees including their mental health needs and increased suicide risk. The growing availability and popularity of direct-to-consumer genetic testing kits amplifies the need for PCPs to be prepared to address genetic testing for adoptees with LFMH. This study explores PCP training and approaches to adult adopted patients with LFMH. We used critical adoption studies as a theoretical framework for this study to understand how adoptive identity might shape clinical experiences. We recruited PCPs from Minnesota and Rhode Island via purposive, criteria-based, reputational sampling. We conducted hour-long semistructured qualitative interviews incorporating hypothetical clinical vignettes. Transcripts were coded via template organizing method and analyzed via Immersion-Crystallization. We interviewed 23 PCPs. They reported receiving little training or resources on adult adoptees with LFMH and showed substantial knowledge gaps regarding mental health and genetic testing for this population. Many failed to adjust history-taking and primary care approaches, which they recognized as potentially resulting in inaccuracies, inappropriate clinical care, and microaggressions while inadvertently triggering anxiety, shame, and distrust among patients. A mismatch between adopted patients' and physicians' understandings of family medical history could strain the therapeutic relationship. Nearly all interviewees viewed additional training to care for adult adoptees with LFMH as beneficial. Future research should expand education and training for PCPs on adult adoptees with LFMH.

Implementing an Adverse Childhood Experiences Screening Tool With Migrant Children: A Quality Improvement Project Using the PEARLS Screening Tool

Implementing an Adverse Childhood Experiences Screening Tool With Migrant Children: A Quality Improvement Project Using the PEARLS Screening Tool

Understanding Adolescent Risk Behaviors: Insights from a School-Based Health Student Survey

Adolescence is a critical phase for establishing lifelong health behaviors; however, its often marked by risky practices that face significant health problems. This study explored the prevalence of risky health behaviors among 252 high school students aged 15–18 years using the Global School-Based Student Health Survey (GSHS). This survey assesses reproductive health awareness, smoking habits, HIV/AIDS knowledge, and physical activity. The results revealed that over half (53%) of the students lacked basic awareness of reproductive health, including safe practices and risk identification. Smoking behavior was reported by 19% of students, with some initiating as early as age 10 years old, influenced significantly by peer pressure. Less than 40% of students understanding about HIV/AIDS transmission and prevention. Furthermore, physical inactivity was prevalent, with more than 60% of students engaging in less than the recommended 60 minutes of daily physical activity. These results highlight critical deficiencies in adolescent health knowledge and behaviors, emphasizing the need for targeted, school-based health education programs. Comprehensive initiatives focusing on reproductive health, smoking prevention, HIV/AIDS awareness, and physical activity promotion are essential to empower students to make informed choices and adopt healthier lifestyles, reducing their long-term health risks.

LIFE COURSE “COGNABILITY”: INVESTIGATING NEIGHBORHOODS AND COGNITIVE HEALTH RISKS ACROSS THE LIFESPAN

Abstract A growing body of evidence identifies potentially modifiable individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD) such as physical inactivity, hypertension, and social isolation. However, the neighborhood built and social environments in which people develop and navigate these risk factors are often overlooked. This knowledge gap is particularly acute for longitudinal neighborhood contexts that may differentially structure opportunities and barriers to individual ADRD risk across the lifespan. The Neighborhoods and Health at All Ages Study employed seated and mobile interviews from August 2023-March 2024 to investigate which neighborhood amenities and hazards are perceived as most relevant to cognitive health-promoting activities at different life course stages. Fifty-six study participants living across the Minneapolis-St. Paul (MN) metropolitan area were on average 42 years old (range: 18-75). 52% identified as female, 40% male, 8% non-binary; and 29% identified as Asian, 24% Hispanic, 19% Black/African American, 17% non-Hispanic White, and 11% American Indian/Alaska Native. Reflexive thematic analysis identified that greater access to affordable amenities, online social infrastructure, and robust public and active transit in young adulthood; safe transportation, online neighborhood swaps, and educational sites (e.g., daycares, schools) in mid-life; and civic/social organizations, arts/cultural amenities, and accessible outdoor recreation in later life can support cognitively healthy lifestyle behaviors. The interviews captured nuanced perspectives and varying personal experiences of how individuals uniquely engage with their neighborhood environments, including navigating structural racism, classism, and ageism. Results may inform upstream community-level interventions to help create more equitable neighborhoods with opportunities to support lifelong cognitive health.

CREATING OPPORTUNITIES TO IMPROVE AGE INCLUSIVITY IN HIGHER EDUCATION: AN INNOVATIVE EDUCATION PROGRAM EXAMPLE

Abstract The Centre on Aging at the University of Manitoba (UM) leads the UM Age-friendly University (AFU) Committee and has taken on many initiatives to enhance the age inclusivity of the University, since 2016. In 2021, the Centre held a competition called the Age-friendly University Initiative Fund, which was open to all academic and non-academic units at UM. Funded projects related to campus wayfinding (Architectural &amp; Engineering Services and the Office of Sustainability), inter-generational arts presentations/workshops (School of Art Gallery), technology training (Alumni Relations), and the development of a micro-certificate on Facilitating Older Adult Learning (FOAL; Faculty of Extended Education). This presentation will provide an overview of the Age-friendly University Initiative Fund and its collaborative process of working with funded projects, as well as provide specific details on the development and implementation of the micro-certificate. The FOAL micro-certificate provides a professional development opportunity to take three modules online: older adult development, universal design for learning, and using technology for teaching and learning with older adults. In total there are 36 contact hours for this credential that can be completed in a flexible fashion. The goal of the micro-certificate is to enable individuals to work more effectively with older adults to support their learning, across a broad range of learning environments (e.g., lifelong learning programs, senior centers, health care and therapy settings). Cross-unit collaboration is critical for the effective development and implementation of initiatives to improve age inclusivity across multiple domains such as those described in this presentation.

Effect of Reciprocal Learning in Big Ball Games to Improve Physical Literacy of 12-Year-Old Junior High School Students

Physical literacy is the development of various human movements consisting of basic movement skills and basic sports skills, so that these skills provide tools for humans to do physical activities that improve or maintain lifelong health. On average, students after school do not have time to do physical activities, this shows that awareness of physical activity is very low, in addition, in physical education learning there are still students who lack and have not optimized physical activity, so that motivation, understanding, knowledge and movement activities in children decrease. This study aims to determine the effect of reciprocal learning in big ball games in improving physical literacy in 12-year-old children at the junior high school level. The method in this study uses a randomized control group pretest-posttest design experimental study, this experimental study was conducted on a group with a control or comparison group, the research sample consisted of 12-year-old children at the junior high school level, the research instrument used in this study adopted from the measurement of physical literacy from the Canadian Assessment of Physical Literacy (CAPL). The results in the independent t-test output table in the equal variances assumed section are known to have a Sig (2-tailed) of 0.015 &lt;0.05 so that a decision can be taken that in the independent sample t-test it can be concluded that Ho is rejected and Ha is accepted, thus the results of this study conclude that there is a significant difference in the final test results of reciprocal learning in big ball games in improving physical literacy between the intervention group and the control group.

Parenting influences associated with BMI-for-age z-score of Malaysian children aged 6-36 months: A cross-sectional study based on an online survey

Introduction: Malnutrition in early life can contribute to lifelong health consequences. Both fathers and mothers can influence children’s feeding, eating behaviours, and body weight status. This cross-sectional study aimed to determine the association between parental factors and body mass index-for-age z-score (BAZ) of Malaysian children aged 6-36 months. Methods: An online questionnaire using Google Form, which comprised of socio-demographic factors, parental lifestyle and feeding factors, children’s birth history and eating behaviours, was completed by 282 pairs of fathers and mothers of full-term children during the COVID-19 pandemic. Health records were accessed with parental consent to ensure accurate measurements of children’s weight and length, while both fathers and mothers self-reported their weight and height. Results: Prevalence of at-risk overweight, overweight, and obesity among children was 10.7%, 2.8%, and 1.1%, respectively, while wasting and severe wasting was 5.7% and 0.4%, respectively. Multiple linear regression analysis found that higher birth weight (β=0.271, p&lt;0.001), less frequent use of food to calm by fathers (β=-0.127, p=0.035), and higher maternal BMI (β=0.136, p=0.021) significantly contributed to higher BAZ among children. Conclusion: These findings suggest that interventions should involve both fathers and mothers with a focus on nutrition education in promoting responsive feeding, such as minimising use of food, to calm children. Additionally, efforts to ensure good nutrition before and during pregnancy to achieve ideal birth weight are equally important.

Challenges in Pedicatric Orthodontics and Radilogy: Evidence from Recent Studies and Implications for Clinical Practice: A Review Article

This narrative review delves into the complex challenges inherent in pediatric orthodontics and radiology, fields pivotal to the early detection, prevention, and management of dental and craniofacial developmental issues in children. Pediatric orthodontics plays a critical role as the first line of defense against malocclusions and jaw discrepancies, aiming to establish a foundation for functional, aesthetic, and lifelong oral health. Concurrently, pediatric radiology provides indispensable insights for accurate diagnosis and effective treatment monitoring, yet it raises significant ethical and safety concerns due to the sensitivity of young patients to ionizing radiation. The review highlights several core challenges: managing patient compliance in long-term orthodontic treatment, navigating the technical and ethical complexities of pediatric radiological practices, and addressing socioeconomic barriers that restrict access to necessary care. It emphasizes the need for innovative approaches in treatment and imaging techniques, such as the development and implementation of low-dose imaging protocols and non-ionizing imaging alternatives like ultrasonography and MRI, which aim to reduce the risks associated with radiation exposure.. The review concludes with a call for a judicious approach to imaging and treatment, advocating for policies that enhance accessibility to orthodontic care and radiological services, particularly for underprivileged populations. The integration of innovative technologies, coupled with a focus on preventive care and early intervention, holds the potential to significantly improve outcomes in pediatric orthodontics and radiology, ensuring better long-term oral and craniofacial health for children. This narrative review serves as a comprehensive examination of the current challenges and emerging solutions in pediatric orthodontics and radiology, emphasizing the need for ongoing research and collaboration to advance patient care and treatment methodologies in these crucial fields.

Dental Care Behaviors and Oral Health Challenges in School-Age Populations

Introduction: Oral health is vital for overall well-being, especially in childhood, as early habits influence lifelong dental health. This survey aims to evaluate oral hygiene habits and patterns among schoolchildren in Saudi Arabia. Methods: The survey utilized a school-based, point-in-time analysis conducted from October 15 to December 15, 2024. Participants were selected using a pure random sampling method to ensure a representative group of schoolchildren. Each participant completed an anonymous, detailed survey on oral hygiene habits, including tooth brushing, flossing, toothbrush ownership, and sharing toothbrushes with family members. The data were coded for analysis. Results: The study revealed poor oral hygiene practices among schoolchildren, with only 369 (23.9%) brushing their teeth twice daily, while 343 (22.2%) never brushed, particularly in western areas 216 (23.2%). Dental flossing was rare (1,503 (97.4%) never used floss), 18.9% lacked a toothbrush, and 292 (14.9%) shared one with family members. Infrequent brushing was significantly linked to gum bleeding, highlighting a greater risk of dental issues and the urgent need for community-focused oral health interventions. Conclusion: This study underscores the need for community-based oral health education programs, early interventions, and increased awareness to improve oral hygiene and prevent dental diseases in the population

The Effectiveness of the ‘My Hands are Clean Program’ Based on the Health Promotion Model Conducted with Virtual Reality Method

Objective: Hand hygiene is very important as the hand is the organ that contains the most microorganisms. On the other hand, the school environment is an important environment for raising awareness of hand hygiene and acquiring handwashing behavior. This research was conducted to determine the effectiveness of the ‘My Hands are Clean Program’, which is carried out with the virtual reality method based on the health promotion model. Methods: This research is a quasi-experimental study with a pre-test and post-test model. The research population is 4th-8th grades in a school. Data were collected by socio-demographic characteristics form, hand hygiene observation form, and decision scale. Measurements were made before the training, after the training, the first follow-up after one month and the second follow-up after two months. Data were analyzed using IBM SPSS 26.0, Kolmogorov-Smirnov, Wilcoxon Test, Fridman Test, Mann Whitney U test, Kruskal Wallis test, and Bonferroni-corrected pairwise comparisons in further analysis. The “TREND checklist” was used to report it. Results: The students got the highest score on the hand hygiene observation form at the first follow-up. It was determined that students’ post-test, first follow-up and second follow-up mean scores were significantly higher than the pre-test mean scores. In Gpower Post hoc power analysis, the power of the study was determined to be 99%. Conslusion: It can be said that the use of technology-based methods in developing handwashing behavior, which will affect lifelong health, is effective for school-age students.

CXCL4 deficiency limits M4 macrophage infiltration and attenuates hyperoxia-induced lung injury

BackgroundBronchopulmonary dysplasia (BPD), a chronic lung disease prevalent among premature infants, significantly impacts lifelong respiratory health. Macrophages, as key components of the innate immune system, play a role in lung tissue inflammation and injury, exhibiting diverse and dynamic functionalities. The M4 macrophage, a distinctive subtype primarily triggered by chemokine (C-X-C motif) ligand 4 (CXCL4), has been implicated in pulmonary inflammatory and fibrotic processes. Nonetheless, its contribution to the pathophysiology of BPD remains uncertain.ObjectiveThis study aimed to elucidate the involvement of CXCL4 in hyperoxia-induced neonatal lung injury and fibrosis, with a particular focus on its influence on M4 macrophages.MethodsA BPD model in neonatal mice was established through continuous exposure to 95% O2 for 7 days. Comparative analyses of lung damage and subsequent regeneration were conducted between wild-type (WT) and CXCL4 knockout (KO) mice. Lung tissue inflammation and fibrosis were assessed using histological and immunofluorescence staining, enzyme-linked immunosorbent assay, Western blot, and real-time quantitative polymerase chain reaction. Differentiation of M0 and M4 macrophages was performed in vitro using macrophage colony-stimulating factor and CXCL4, while expressions of S100A8 and MMP7, along with migration assays, were evaluated.ResultsElevated CXCL4 levels and M4 macrophage activation were identified in the lung tissue of BPD model mice. CXCL4 deficiency conferred protection to alveolar type 2 epithelial cells, reduced sphingosine-1-phosphate metabolic activity, mitigated pulmonary fibrosis, and limited M4 macrophage progression. This deletion further enhanced lung matrix remodeling during recovery. In vitro, CXCL4 promoted M4 macrophage differentiation and increased macrophage migration via chemokine (C-C motif) receptor 1.ConclusionCXCL4 contributes to hyperoxia-induced lung injury and fibrosis through modulation of cytokine release, alveolar cell proliferation, lipid metabolism, and the regulation of macrophage phenotype and function.