Neonatal-Perinatal Medicine Fellow Childrens Hospital of Philadelphia Philadelphia, Pennsylvania, United States
Background: Preterm birth is the leading cause of infant mortality worldwide. Many of the morbidities that impact preterm infants, including bronchopulmonary dysplasia (BPD), stem from maladaptation of the immune system to an unexpected and medicalized post-natal life. However, it has proved difficult to use the immune system to stratify infants by BPD risk because knowledge of the preterm immune system is murky. This study aims to detail the complete preterm immune network with a combination of deep cellular analysis and proteomics to identify immune profiles of infants who ultimately develop BPD. Objective: This ongoing study uses novel 41-marker cytometry by time of flight (CyTOF) and 92-protein oligonucleotide-linked (Olink) proteomics to detail peripheral blood immune cells and proteins in preterm infants as they change after birth. The goals of the study are to 1) map the post-natal development of the preterm infant immune system, and to 2) identify immune profiles of infants that go on to develop BPD. We hypothesize that features of the preterm immune profile will change in a coordinated manner by corrected gestational age (cGA), and that infants who develop BPD will have immune features that distinguish them from infants who do not. Design/Methods: We are scavenging whole blood remaining after clinical lab analysis approximately every two weeks from preterm infants born between 23w0d gestational age (GA) and 32w6d GA at the Hospital of University of Pennsylvania NICU. We are then assessing each sample with CyTOF and Olink analysis and using non-parametric statistical modeling to identify commonalities and variation over time, across age, corrected gestational age, weight, compared to healthy term infants, and compared to healthy adults. We are also collecting clinical data for the infants in the study, and identifying features that correlate with BPD diagnosis. This approach has been approved as minimal risk by the Penn Institutional Review Board (IRB). We have enrolled 26 infants thus far and anticipate completing the study in early spring 2024.
