The Association of Patent Ductus Arteriosus with Inflammation: A Narrative Review of the Role of Inflammatory Biomarkers and Treatment Strategy in Premature Infants

Int J Mol Sci. 2022 Nov 10;23(22):13877. doi: 10.3390/ijms232213877.

Abstract

Patent ductus arteriosus (PDA) is a common cardiovascular complication that complicates clinical care in the intensive care of premature infants. Prenatal and postnatal infections and the inflammation process can contribute to PDA, and intrauterine inflammation is a known risk factor of PDA. A variety of inflammatory biomarkers have been reported to be associated with PDA. Chorioamnionitis induces the fetal inflammatory process via several cytokines that have been reported to be associated with the presence of PDA and may have a role in the vascular remodeling process or vessel dilation of the ductus. On the other hand, anti-inflammatory agents, such as antenatal steroids, decrease PDA incidence and severity in patients born to those with chorioamnionitis. Proinflammatory cytokines, which are expressed more significantly in preterm neonates and chorioamnionitis, are associated with the presence of PDA. In this review, we focus on the pathogenesis of PDA in preterm infants and the role of biomarkers associated with the perinatal inflammatory process.

Keywords: chorioamnionitis; ductus arteriosus; intrauterine inflammation; preterm infants.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Chorioamnionitis*
  • Cytokines
  • Ductus Arteriosus, Patent* / pathology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases*
  • Inflammation / complications
  • Pregnancy

Substances

  • Biomarkers
  • Cytokines

Grants and funding

This work was supported by the Ministry of Science and Technology, Taiwan (MOST 108–2314-B-006-065 MY2; MOST-110–2314-B-006–048-MY2) granted to J.-N. Wang. This work was also funded by the intramural grant NCKUH-11105003 granted to Y.-J. Wei and T.-W. Wong acknowledges funding from National Cheng Kung University Hospital, Taiwan [NCKUH-11104041], and the Center of Applied Nanomedicine, National Cheng Kung University from the Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE). The APC was funded by NCKUH-11105003.