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Browsing by Author "Ryan, Rita M."
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Item Bronchopulmonary Dysplasia: Executive Summary of a Workshop(Elsevier, 2018-06) Higgins, Rosemary D.; Jobe, Alan H.; Koso-Thomas, Marion; Bancalari, Eduardo; Viscardi, Rose M.; Hartert, Tina V.; Ryan, Rita M.; Kallapur, Suhas G.; Steinhorn, Robin H.; Konduri, Girija G.; Davis, Stephanie D.; Thebaud, Bernard; Clyman, Ronald I.; Collaco, Joseph M.; Martin, Camilia R.; Woods, Jason C.; Finer, Neil N.; Raju, Tonse N. K.; Pediatrics, School of MedicineComment in Bronchopulmonary Dysplasia: The Ongoing Search for One Definition to Rule Them All. [J Pediatr. 2018] Midlife crisis? In its 50th year, BPD redefines itself. [J Pediatr. 2018]Item T cell developmental arrest in former premature infants increases risk of respiratory morbidity later in infancy(American Society for Clinical Investigation, 2018-02-22) Scheible, Kristin M.; Emo, Jason; Laniewski, Nathan; Baran, Andrea M.; Peterson, Derick R.; Holden-Wiltse, Jeanne; Bandyopadhyay, Sanjukta; Straw, Andrew G.; Huyck, Heidie; Ashton, John M.; Tripi, Kelly Schooping; Arul, Karan; Werner, Elizabeth; Scalise, Tanya; Maffett, Deanna; Caserta, Mary; Ryan, Rita M.; Reynolds, Anne Marie; Ren, Clement L.; Topham, David J.; Mariani, Thomas J.; Pryhuber, Gloria S.; Pediatrics, School of MedicineThe inverse relationship between gestational age at birth and postviral respiratory morbidity suggests that infants born preterm (PT) may miss a critical developmental window of T cell maturation. Despite a continued increase in younger PT survivors with respiratory complications, we have limited understanding of normal human fetal T cell maturation, how ex utero development in premature infants may interrupt normal T cell development, and whether T cell development has an effect on infant outcomes. In our longitudinal cohort of 157 infants born between 23 and 42 weeks of gestation, we identified differences in T cells present at birth that were dependent on gestational age and differences in postnatal T cell development that predicted respiratory outcome at 1 year of age. We show that naive CD4+ T cells shift from a CD31-TNF-α+ bias in mid gestation to a CD31+IL-8+ predominance by term gestation. Former PT infants discharged with CD31+IL8+CD4+ T cells below a range similar to that of full-term born infants were at an over 3.5-fold higher risk for respiratory complications after NICU discharge. This study is the first to our knowledge to identify a pattern of normal functional T cell development in later gestation and to associate abnormal T cell development with health outcomes in infants.Item Urine Gastrin Releasing Peptide in the First Week Correlates with BPD and Post-Prematurity Respiratory Disease(Wiley, 2020-04) Voynow, Judith A.; Fisher, Kimberley; Sunday, Mary E.; Cotton, C. Michael; Hamvas, Aaron; Hendricks-Muñoz, Karen D.; Poindexter, Brenda B.; Pryhuber, Gloria S.; Ren, Clement L.; Ryan, Rita M.; Sharp, Jack K.; Young, Sarah P.; Zhang, Haoyue; Greenberg, Rachel G.; Herring, Amy H.; Davis, Stephanie D.; Pediatrics, School of MedicineRationale: Bronchopulmonary dysplasia (BPD) is associated with post-prematurity respiratory disease (PRD) in survivors of extreme preterm birth. Identifying early biomarkers that correlate with later development of BPD and PRD may provide insights for intervention. In a preterm baboon model, elevated gastrin-releasing peptide (GRP) is associated with BPD, and GRP inhibition mitigates BPD occurrence. Objective: We performed a prospective cohort study to investigate whether urine GRP levels obtained in the first postnatal week were associated with BPD, PRD, and other urinary biomarkers of oxidative stress. Methods: Extremely low gestational age infants (23-28 completed weeks) were enrolled in a US multicenter observational study, The Prematurity and Respiratory Outcomes Program (http://clinicaltrials.gov/ct2/show/NCT01435187). We used multivariable logistic regression to examine the association between urine GRP in the first postnatal week and multiple respiratory outcomes: BPD, defined as supplemental oxygen use at 36 + 0 weeks postmenstrual age, and post-PRD, defined by positive quarterly surveys for increased medical utilization over the first year (PRD score). Results: A total of 109 of 257 (42%) infants had BPD, and 120 of 217 (55%) had PRD. On adjusted analysis, GRP level more than 80 was associated with BPD (adjusted odds ratio [aOR], 1.83; 95% confidence interval [CI], 1.03-3.25) and positive PRD score (aOR, 2.46; 95% CI, 1.35-4.48). Urine GRP levels correlated with duration of NICU ventilatory and oxygen support and with biomarkers of oxidative stress: allantoin and 8-hydroxydeoxyguanosine. Conclusions: Urine GRP in the first postnatal week was associated with concurrent urine biomarkers of oxidative stress and with later diagnoses of BPD and PRD.