Cord blood T-Cell imbalances as early predictors of bronchopulmonary dysplasia in extremely preterm neonates.
8 affiliations
- 1Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
- 2Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Institute of Neuroscience, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
- 3Department of Laboratory Medicine, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
- 4Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Institute of Neuroscience, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. [email protected].
- 5Center for Perinatal Medicine and Health, Institute of Clinical Science, University of Gothenburg, Gothenburg, Sweden. [email protected].
- 6Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. [email protected].
- 7Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. [email protected].
- 8Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Institute of Neuroscience, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. [email protected].
Abstract
Background
Bronchopulmonary 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
In 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
Among 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
Extremely 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.
Related
- Renal outcome at 2 years in neonates with nephrocalcinosis and bronchopulmonary dysplasia: a case-control study.
- Effects of Neurally Adjusted Ventilatory Assist on Lung Ultrasound Aeration and Diaphragmatic Function in Extremely Preterm Infants With Evolving or Established Bronchopulmonary Dysplasia.
- Early Tracheal and Salivary miRNAs in Extremely Preterm Infants Predict Bronchopulmonary Dysplasia-Related Pulmonary Hypertension.
- Early prophylactic low-dose hydrocortisone for bronchopulmonary dysplasia prevention in extremely preterm infants: a systematic review and meta-analysis
- Burden and predictors of bronchopulmonary dysplasia in preterm infants: A seven-year cohort
BibTeX
@article{li2026cord,
title = {{Cord blood T-Cell imbalances as early predictors of bronchopulmonary dysplasia in extremely preterm neonates.}},
author = {Yuandan Li and Yanran Xue and Lingling Zhang and Yiran Xu and Xiaochan Guo and Xiaoli Zhang and Hongwei Li and Yu Yang and Yimeng Wang and Xiaofan Zhu and Huijuan Wang and Xiaoxiao Jing and Changlian Zhu and Falin Xu},
journal = {Respiratory research},
year = {2026},
month = oct,
doi = {10.1186/s12931-026-03887-w},
url = {https://europepmc.org/article/MED/42907816},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Cord blood T-Cell imbalances as early predictors of bronchopulmonary dysplasia in extremely preterm neonates.
AU - Yuandan Li
AU - Yanran Xue
AU - Lingling Zhang
AU - Yiran Xu
AU - Xiaochan Guo
AU - Xiaoli Zhang
AU - Hongwei Li
AU - Yu Yang
AU - Yimeng Wang
AU - Xiaofan Zhu
AU - Huijuan Wang
AU - Xiaoxiao Jing
AU - Changlian Zhu
AU - Falin Xu
PY - 2026
DA - 2026/10/19
JO - Respiratory research
DO - 10.1186/s12931-026-03887-w
UR - https://europepmc.org/article/MED/42907816
AB - Background Bronchopulmonary 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 In 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 Among 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 Extremely 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.
SN - 1465-9921
SN - 1465-993X
ER -