Proteomic Analysis of Nasopharyngeal Aspirate Biomarkers for Prematurity-Related Bronchopulmonary Dysplasia.

BACKGROUND

The high incidence of bronchopulmonary dysplasia (BPD) continues to be a problem among extremely low-gestational-age neonates (ELGANs). Recent improvements in next-generation proteomics have provided opportunities to obtain new perspectives on the early detection of BPD. In this study, our main objectives were to study the proteomes of patients by collecting nasopharyngeal aspirate (NPA) samples and evaluate the differences between ELGANs with and without BPD at 1 week of life.

RESEARCH QUESTION: Is it possible to identify differential NPA biomarkers for the early detection of BPD at 1 week of life?

STUDY DESIGN AND

METHODS

A cohort of infants without and with BPD born before 30 gestational weeks was selected. NPA samples were collected 1 week after birth by trained nurses and processed for next-generation proteomics using relevant protocols. The resulting protein matrix was used for exploratory, differential expression, and functional enrichment analyses; modeling; and variable reduction.

RESULTS

The data from 131 ELGANs (74 without BPD, 43 with BPD, and 14 deceased) were included. The optimal area under the curve (AUC) values were reached via sparse partial least discrimination analysis (2 components: AUC, 0.95; 95% CI, 0.91-0.99; P < .001). Seventy-three differentially expressed proteins were identified (|log2(fold change)| > 0.58; P < .05). The functional enrichment analysis revealed functions closely related to BPD. An initial 7 biomarker panel displayed a high AUC (0.91; 95% CI, 0.85-0.96). Reduction to 3 biomarkers was effective (0.82; 95% CI, 0.74-0.90).

INTERPRETATION: The results of this study indicate that studying the proteomes of NPA samples can aid in early BPD diagnosis at 1 week of age in infants born before 30 weeks of gestation. This approach may be useful for increasing the understanding of BPD pathophysiology in ELGANs.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT04785859; URL: www.

CLINICALTRIALS: gov.