Inside Pediatrics Magazine Fall/Winter 2025

The team is also studying mitophagy, the elimination of damaged mitochondria through autophagy, and its role in lung development. Emerging evidence suggests that impaired mitophagy contributes to persistent mitochondrial dysfunction, exacerbating lung injury in preterm infants. As a result of this new evidence, the group is also evaluating the potential of thyroid hormone supplementation as a therapeutic strategy to restore mitochondrial function and mitigate lung damage. By integrating clinical data with mouse models, the UAB team is uniquely positioned to investigate both the mechanistic underpinnings of BPD and potential interventions. The collaborative effort spans neonatology, mitochondrial biology and pediatric pulmonology, creating a comprehensive research environment. “Our ultimate aim is to shift the paradigm from reactive to predictive personalized neonatal care,” Kandasamy said. “Understanding how mitochondrial genetics intersect with environmental exposures can help us identify at-risk infants earlier and intervene more effectively.” ●

Chest X-ray of a child with bronchopulmonary dysplasia

An especially promising area of research is platelet bioenergetics. By measuring how platelets utilize mitochondrial energy, the researchers hope to identify specific biomarkers that reflect systemic mitochondrial health and may help predict BPD risk. “Platelets are easy to access and give us a real-time snapshot of mitochondrial function without invasive procedures,” Kandasamy noted.

Children’s of Alabama’s work on Bronchopulmonary Dysplasia

to months before diagnosis of that disease. Viral Jain, M.D. has done extensive work related to chorioamnionitis, and one of his studies suggests that infants born early due to chorioamnionitis have chronic lung damage, including

BPD is a major point of focus for the Children’s neonatology team. In addition to Kandasamy’s work on mitochondrial genetics, the team has published other studies designed to predict the onset of the condition, including research done by Namasivayam Ambalavanan, M.D., which shows

BPD. And as you saw in the last issue of Inside Pediatrics, Colm Travers, M.D., developed a device that uses sound waves to improve lung testing in prematurely born babies. The team is also working to develop ways to treat preterm infants, including those who have BPD. For example, a study led by Waldemar Carlo, M.D., shows that preterm infants receiving caffeine treatment were apnea free sooner than those who did not.

that physiologic data can predict unfavorable respiratory outcomes, such as BPD, in extremely preterm infants. Kent Willis, M.D., also recently published a study that concludes that the gut composition of fungi in the second week of life predicts the later development of BPD, weeks

For more on the work the Children’s neonatology team is doing related to BPD, search “neonatology" at InsidePeds.org.

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