Journal of Clinical Pediatrics >
Study on the role and mechanism of caffeine citrate in the treatment of bronchopulmonary dysplasia in preterm infants
Received date: 2025-03-26
Accepted date: 2025-05-26
Online published: 2025-06-27
Objective To explore the role and mechanism of caffeine citrate in the treatment of bronchopulmonary dysplasia (BPD) in premature infants. Methods Hyperoxic BPD models of neonatal rats and MLE-12 lung epithelial cells were constructed, and the control group, hyperoxic group, and low, medium, and high dose of caffeine citrate intervention groups were set up respectively. The effects of caffeine citrate were evaluated using H&E staining, immunofluorescence staining, CCK8 apoptosis assay, and flow cytometry apoptosis detection. The occurrence of mitochondrial stress and apoptosis was further detected by reactive oxygen species (ROS) immunofluorescence assay, electron microscopy observation, and western blot assay. Results Caffeine citrate intervention increased the survival rate, promoted the body weight gain, and ameliorated the lung tissue injury in neonatal rats after hyperoxia exposure. Caffeine citrate intervention increased the survival rate of MLE-12 cells, reduced the loss of surfactant protein C (SPC), and inhibited apoptosis. In terms of mechanism of action, caffeine citrate reduced the level of reactive oxygen species (ROS), repaired mitochondrial structure, and regulated the expression of proteins related to mitochondrial stress pathways (eIF2α-ATF4-CHOP) and mitochondrial apoptotic pathways (Bax, Bcl2 and Cleaved caspase-3). Conclusions Caffeine citrate ameliorates hyperoxia-induced lung injury by repairing mitochondrial function and inhibiting oxidative stress and apoptosis, which plays an active role in the treatment of BPD in preterm infants.
SHI Hui , WANG Yiwen . Study on the role and mechanism of caffeine citrate in the treatment of bronchopulmonary dysplasia in preterm infants[J]. Journal of Clinical Pediatrics, 2025 , 43(7) : 525 -531 . DOI: 10.12372/jcp.2025.25e0298
| [1] | Thébaud B, Goss KN, Laughon M, et al. Broncho-pulmonary dysplasia[J]. Nat Rev Dis Primer, 2019, 5(1): 78. |
| [2] | Cao Y, Jiang S, Sun J, et al. Assessment of neonatal intensive care unit practices, morbidity, and mortality among very preterm infants in China[J]. JAMA Netw Open, 2021, 4(8): e2118904. |
| [3] | 任淑英, 张勤. 呼吸道微生态的影响因素及其在支气管肺发育不良中的意义[J]. 临床儿科杂志, 2023, 41(10): 715-720. |
| Ren SY, Zhang Q. Influencing factors of respiratory tract microecology and its significance in bronchopulmonary dysplasia[J]. Linchuang Erke Zazhi, 2023, 41(10): 715-720. | |
| [4] | Jensen EA, Edwards EM, Greenberg LT, et al. Severity of bronchopulmonary dysplasia among very preterm infants in the United States[J]. Pediatrics, 2021, 148(1): e2020030007. |
| [5] | Ericsson AC. Bronchopulmonary dysplasia: a crime of opportunity[J]. Eur Respir J, 2020, 55(5): 2000551. |
| [6] | Gilfillan M, Bhandari A, Bhandari V. Diagnosis and management of bronchopulmonary dysplasia[J]. BMJ, 2021: n1974. |
| [7] | Hennelly M, Greenberg RG, Aleem S. An update on the prevention and management of bronchopulmonary dysplasia[J]. Pediatric Health Med Ther, 2021, 12: 405-419. |
| [8] | Moschino L, Zivanovic S, Hartley C, et al. Caffeine in preterm infants: where are we in 2020?[J]. ERJ Open Res, 2020, 6(1): 00330-2019. |
| [9] | Bruschettini M, Brattstr?m P, Russo C, et al. Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity[J]. Cochrane Database Syst Rev, 2023, 4(4): CD013873. |
| [10] | Pritchard KA Jr, Jing X, Teng M, et al. Role of endoplasmic reticulum stress in impaired neonatal lung growth and bronchopulmonary dysplasia[J]. PLoS One, 2022, 17(8): e0269564. |
| [11] | Li MD, Fu L, Lv BB, et al. Arsenic induces ferroptosis and acute lung injury through mtROS-mediated mitochondria-associated endoplasmic reticulum membrane dysfunction[J]. Ecotoxicol Environ Saf, 2022, 238: 113595. |
| [12] | He F, Wang QF, Li L, et al. Melatonin protects against hyperoxia-induced apoptosis in alveolar epithelial type II cells by activating the MT2/PI3K/AKT/ETS1 signaling pathway[J]. Lung, 2023, 201(2): 225-234. |
| [13] | Liu C, Fu C, Sun Y, et al. Itaconic acid regulation of TFEB-mediated autophagy flux alleviates hyperoxia-induced bronchopulmonary dysplasia[J]. Redox Biol, 2024, 72: 103115. |
| [14] | Jing X, Huang YW, Jarzembowski J, et al. Caffeine ameliorates hyperoxia-induced lung injury by protecting GCH1 function in neonatal rat pups[J]. Pediatr Res, 2017, 82(3): 483-489. |
| [15] | Teng M, Wu T J, Jing X, et al. Temporal dynamics of oxidative stress and inflammation in bronchopulmonary dysplasia[J]. Int J Mol Sci, 2024, 25(18): 10145. |
| [16] | Wang X, Lv S, Sun J, et al. Caffeine reduces oxidative stress to protect against hyperoxia-induced lung injury via the adenosine A2A receptor/cAMP/PKA/src/ERK1/2/p38MAPK pathway[J]. Redox Rep, 2022, 27(1): 270-278. |
| [17] | Tong X, Li M, Liu N, et al. Hyperoxia induces endoplasmic reticulum stress-associated apoptosis via the IRE1α pathway in rats with bronchopulmonary dysplasia[J]. Mol Med Rep, 2021, 23(1): 33. |
| [18] | Yang M, Chen Y, Huang X, et al. ETS1 ameliorates hyperoxia-induced bronchopulmonary dysplasia in mice by activating Nrf2/HO-1 mediated ferroptosis[J]. Lung, 2023, 201(4): 425-441. |
| [19] | Wang M, Zhang F, Ning X, et al. Regulating NLRP3 inflammasome-induced pyroptosis via Nrf2: TBHQ limits hyperoxia-induced lung injury in a mouse model of bronchopulmonary dysplasia[J]. Inflammation, 2023, 46(6): 2386-2401. |
| [20] | Zhang S, Li X, Yuan T, et al. Glutamine inhibits inflammation, oxidative stress, and apoptosis and ameliorates hyperoxic lung injury[J]. J Physiol Biochem, 2023, 79(3): 613-623. |
| [21] | Sousa AAP, Chaves LDS, Tarso Facundo H. Mitochondrial electron transport chain disruption and oxidative stress in lipopolysaccharide-induced cardiac dysfunction in rats and mice[J]. Free Radic Res, 2025 May 15:1-15. |
| [22] | Poonyagariyagorn HK, Metzger S, Dikeman D, et al. Superoxide dismutase 3 dysregulation in a murine model of neonatal lung injury[J]. Am J Respir Cell Mol Biol, 2014, 51(3): 380-390. |
| [23] | Di S, Fan C, Ma Z, et al. PERK/eIF-2α/CHOP pathway dependent ROS generation mediates butein-induced non-small-cell lung cancer apoptosis and G2/M phase arrest[J]. Int J Biol Sci, 2019, 15(8): 1637-1653. |
/
| 〈 |
|
〉 |