Evidence map›Paper›PMID 38066248›Full record

ArticlePediatric research2024

Postnatal steroids as lung protective and anti-inflammatory in preterm lambs exposed to antenatal inflammation.

Paris C Papagianis, Peter B Noble, Siavash Ahmadi-Noorbakhsh, Donna Savigni, Timothy J M Moss, J Jane Pillow

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Article in Pediatric research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Paris C PapagianisDepartment of Pharmacology, School of Medicine, Nursing and Health Sciences, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia. paris.papagianis@monash.edu.
Peter B NobleSchool of Human Sciences, The University of Western Australia, Crawley, WA, Australia.
Siavash Ahmadi-NoorbakhshSchool of Human Sciences, The University of Western Australia, Crawley, WA, Australia.
Donna SavigniSchool of Human Sciences, The University of Western Australia, Crawley, WA, Australia.
Timothy J M MossDepartment of Obstetrics and Gynaecology, School of Clinical Health Sciences, Monash University, Clayton, VIC, Australia.
J Jane PillowSchool of Human Sciences, The University of Western Australia, Crawley, WA, Australia.
University of Western Australia · AUAustralian Regenerative Medicine Institute · AUMonash University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLung inflammation and impaired alveolarization precede bronchopulmonary dysplasia (BPD). Glucocorticoids are anti-inflammatory and reduce ventilator requirements in preterm infants. However, high-dose glucocorticoids inhibit alveolarization. The effect of glucocorticoids on lung function and structure in preterm newborns exposed to antenatal inflammation is unknown. We hypothesise that postnatal low-dose dexamethasone reduces ventilator requirements, prevents inflammation and BPD-like lung pathology, following antenatal inflammation.

methodsPregnant ewes received intra-amniotic LPS (E.coli, 4 mg/mL) or saline at 126 days gestation; preterm lambs were delivered 48 h later. Lambs were randomised to receive either tapered intravenous dexamethasone (LPS/Dex, n = 9) or saline (LPS/Sal, n = 10; Sal/Sal, n = 9) commencing <3 h after birth. Respiratory support was gradually de-escalated, using a standardised protocol aimed at weaning from ventilation towards unassisted respiration. Tissues were collected at day 7.

resultsLung morphology and mRNA levels for inflammatory mediators were measured. Respiratory support requirements were not different between groups. Histological analyses revealed higher tissue content and unchanged alveolarization in LPS/Sal compared to other groups. LPS/Dex lambs exhibited decreased markers of pulmonary inflammation compared to LPS/Sal.

conclusionTapered low-dose dexamethasone reduces the impact of antenatal LPS on ventilation requirements throughout the first week of life and reduces inflammation and pathological thickening of the preterm lung IMPACT: We are the first to investigate the combination of antenatal inflammation and postnatal dexamethasone therapy in a pragmatic study design, akin to contemporary neonatal care. We show that antenatal inflammation with postnatal dexamethasone therapy does not reduce ventilator requirements, but has beneficial maturational impacts on the lungs of preterm lambs at 7 days of life. Appropriate tapered postnatal dexamethasone dosing should be explored for extuabtion of oxygen-dependant neonates.

Indexed as

Bronchopulmonary DysplasiaLipopolysaccharidesAnimalsAnti-Inflammatory AgentsDexamethasoneFemaleGlucocorticoidsHumansInfantInfant, NewbornInfant, PrematureInflammationLungPregnancySheepSheep, DomesticAnti-Inflammatory AgentsDexamethasoneGlucocorticoidsLipopolysaccharidesSteroids

Identifiers

PMID38066248
OpenAlexW4389478339

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.