{ "abstract": "Background\n\nBronchopulmonary dysplasia (BPD) is a major morbidity among extremely preterm neonates and has been increasingly linked to dysregulated early-life immune responses. whether cord blood T-cell subset profiles can identify neonates at increased risk of BPD remains unclear. We examined the association between cord blood immune cell subsets and the subsequent BPD and explore immunological measures could improve early risk prediction when combined with clinical variables.Methods\n\nIn this prospective cohort study, 75 extremely preterm infants born before 32 weeks of gestation were enrolled at birth. High-parameter flow cytometry was used to quantify innate and adaptive immune cell populations from umbilical cord arterial blood. Clinical data were collected, and BPD was diagnosed at 36 weeks' postmenstrual age. Multivariable regression and least absolute shrinkage and selection operator regression were conducted to identify cord immune features associated with BPD and to develop an exploratory prediction model.Results\n\nAmong 75 infants, 31 developed BPD and 44 did not. After adjustment for gestational age, birth weight, duration of mechanical ventilation and amniotic inflammatory syndrome, infants who developed BPD had lower cord blood proportions of CD3⁺ T cells, CD4⁺ T cells, and regulatory T cells, as well as a lower CD4⁺/CD8⁺ T-cell ratio. Least absolute shrinkage and selection operator regression retained pulmonary hemorrhage, regulatory T-cell proportion, duration of oxygen therapy, and intraventricular hemorrhage for the final prediction model. The resulting nomogram showed high apparent discrimination, with an area under the receiver operating characteristic curve of 0.959. Decision curve analysis suggested potential clinical utility across a range of threshold probabilities.Conclusion\n\nExtremely preterm infants who developed BPD showed altered cord blood T-cell profiles at birth, particularly reduced regulatory T-cell proportions. A nomogram incorporating regulatory T-cell proportion and selected clinical risk factors may support early identification of infants at increased risk of BPD.", "abstract_shown": true, "affiliations": [ "Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.", "Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Institute of Neuroscience, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.", "Department of Laboratory Medicine, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.", "Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Institute of Neuroscience, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. changlian.zhu@neuro.gu.se.", "Center for Perinatal Medicine and Health, Institute of Clinical Science, University of Gothenburg, Gothenburg, Sweden. changlian.zhu@neuro.gu.se.", "Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. changlian.zhu@neuro.gu.se.", "Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. xufalin@zzu.edu.cn.", "Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Institute of Neuroscience, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. xufalin@zzu.edu.cn." ], "article_type": "research article", "arxiv": null, "author_total": 14, "authors": [ { "affs": [ 0, 1 ], "name": "Yuandan Li" }, { "affs": [ 0 ], "name": "Yanran Xue" }, { "affs": [ 1 ], "name": "Lingling Zhang" }, { "affs": [ 1 ], "name": "Yiran Xu" }, { "affs": [ 0 ], "name": "Xiaochan Guo" }, { "affs": [ 1 ], "name": "Xiaoli Zhang" }, { "affs": [ 2 ], "name": "Hongwei Li" }, { "affs": [ 1 ], "name": "Yu Yang" }, { "affs": [ 0, 1 ], "name": "Yimeng Wang" }, { "affs": [ 0 ], "name": "Xiaofan Zhu" }, { "affs": [ 0 ], "name": "Huijuan Wang" }, { "affs": [ 0, 1 ], "name": "Xiaoxiao Jing" }, { "affs": [ 3, 4, 5 ], "name": "Changlian Zhu", "orcid": "0000-0002-5029-6730" }, { "affs": [ 6, 7 ], "name": "Falin Xu", "orcid": "0000-0003-1910-112X" } ], "bibtex": "https://research.draconitic.com/paper/ecscz9t42shmj.bib", "cited_by": 0, "doi": "10.1186/s12931-026-03887-w", "fulltext_url": "https://europepmc.org/articles/PMC13685347", "id": "ecscz9t42shmj", "issns": [ "1465-9921", "1465-993X" ], "landing_url": "https://europepmc.org/article/MED/42907816", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RC705-779" ], [ "openalex", "2740|Neonatal Respiratory Health Research" ] ], "openalex": "W7222902383", "pdf_url": "https://europepmc.org/articles/PMC13685347?pdf=render", "pmcid": "PMC13685347", "pmid": "42907816", "published": "2026-10-19", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/ecscz9t42shmj.ris", "sources": [ { "first_seen": "2026-10-30T12:19:53Z", "native_id": "MED:42907816", "source": "europepmc", "url": "https://europepmc.org/article/MED/42907816" }, { "first_seen": "2026-10-30T13:46:24Z", "native_id": "9bd230edb5a74a0da8876379d1ee7efc", "source": "doaj", "url": "https://doi.org/10.1186/s12931-026-03887-w" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2740|Neonatal Respiratory Health Research", "subfield": "general" } ], "title": "Cord blood T-Cell imbalances as early predictors of bronchopulmonary dysplasia in extremely preterm neonates.", "title_text": "Cord blood T-Cell imbalances as early predictors of bronchopulmonary dysplasia in extremely preterm neonates.", "type": "peer-reviewed", "updated_at": "2026-10-30T13:46:24Z", "url": "https://research.draconitic.com/paper/ecscz9t42shmj", "venue": "Respiratory research", "versions": [] }