# Physiological Phenotyping of Respiratory Outcomes in Infants Born Premature

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2022 · $748,521

## Abstract

With improved survival of extremely low gestational age newborns, a high incidence of bronchopulmonary
dysplasia (BPD) and respiratory morbidities persist throughout childhood. Premature birth results in impaired
lung alveolar and vascular growth and airways disease. The standard NIH definition of BPD, as based on the
need for oxygen and respiratory support at 36 weeks gestational age, is imprecise and provides a poor surrogate
for persistent respiratory problems throughout childhood. Importantly, premature infants even without the BPD
diagnosis have persistent respiratory disease. Furthermore, BPD is not a homogenous respiratory disease, but
represents a spectrum of airway and parenchymal abnormalities that likely contribute to different clinical
phenotypes and to late respiratory morbidities after NICU discharge. However, the relative roles of small airways
dysfunction and distal lung and vascular disease to late respiratory outcomes after preterm birth remain
unknown. The importance of this problem has been further highlighted at recent NIH Workshops on prematurity
and lung disease, which concluded that improved characterization of respiratory phenotypes after preterm birth
is necessary to better understand disease heterogeneity and variability in outcomes; to accurately identify at risk
infants for late disease; to improve specific therapeutic targets; and to enhance clinical trial design for early
interventions. We have previously demonstrated reduced forced expiratory flows (FEF) and pulmonary diffusion
capacity (DLCO) in BPD infants compared to full term controls; that decrements in FEF and DLCO are not well
correlated with each other; and that each measure likely reflects different contributions to BPD pathophysiology
and late respiratory morbidities. Therefore, we hypothesize that infant respiratory morbidities after preterm birth
are highly variable due to differential impairment of airway, parenchymal and vascular development that can be
characterized as distinct physiologic phenotypes; that the nature and severity of these specific impairments of
lung function are strongly associated with increased respiratory morbidities during infancy; and that proteomic
biomarkers can enhance the physiologic characterization of phenotype and prediction of late respiratory
outcomes.

## Key facts

- **NIH application ID:** 10383746
- **Project number:** 5R01HL145679-04
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Steven Herbert Abman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $748,521
- **Award type:** 5
- **Project period:** 2019-03-01 → 2025-03-01

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10383746

## Citation

> US National Institutes of Health, RePORTER application 10383746, Physiological Phenotyping of Respiratory Outcomes in Infants Born Premature (5R01HL145679-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10383746. Licensed CC0.

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