Neurotrophin Expression in Infants as a Predictor of Respiratory and Neurodevelopmental Outcomes

Study Overview
=================
Brief Summary
-----------------
Important developmental processes continue until the completion of 40 weeks gestation. Even during fetal life, intrinsic and environmental factors determine the balance between health and the onset and development of diseases. Thus, it is crucial to understand the mechanisms that regulate normal development and the pathways that contribute to disease pathogenesis. Neurotrophins are a family of four proteins that support the growth and survival of neurons. Their secretion increases during brain development, when new neurons are being formed and existing ones are branching to assemble complex neuronal circuits. In addition to their role in promoting neuron growth and development, neurotrophins are also a product of neuronal activity. Neurotrophins are also responsible for the maintenance of peripheral sensory neurons, including those in the lungs. Airway innervation is responsible for many aspects of lung function including the regulation of airway smooth muscle tone, mucus secretion, and reactivity; therefore, a physiological expression of neurotrophins in the lungs is required for normal lung function.

Detailed Description
-----------------
Currently, there is no reliable method to identify infants who will have poor neurodevelopmental and respiratory outcomes. The ability to make such predictions would be beneficial for both making care decisions in the neonatal intensive care unit and for identifying infants who require earlier and more intense intervention. We intend to determine if neurotrophins can be utilized to predict an infant's long-term outcomes. Neurotrophins are a family of four proteins that support the growth and survival of neurons. Their levels have been shown to increase with brain development and decrease with brain injury. Neurotrophins have also been associated with development of airway injury in the neonate and later respiratory disease such as asthma. We plan to correlate serum neurotrophin levels with respiratory outcomes and neurological outcomes.

Official Title
-----------------
Neurotrophin Expression in Infants as a Predictor of Respiratory and Neurodevelopmental Outcomes

Conditions
-----------------
Bronchopulmonary Dysplasia, Chronic Lung Disease

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: intubated infants in the Neonatal Intensive Care Unit (NICU) Exclusion Criteria: unwilling or unable to give or obtain informed consent

Ages Eligible for Study
-----------------
Minimum Age: 1 Day
Maximum Age: 4 Months

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation of serum neurotrophins with development for Bronchopulmonary Dysplasia | Neurotrophins include Nerve Growth Factor (NGF) and Brain-factor Neurotrophic Factor (BDNF) | within 48 hours of Neonatal Intensive Care Unit admission | 
| Change in serum neurotrophins with developmental delays in children | Neurotrophins include Nerve Growth Factor (NGF) and Brain-factor Neurotrophic Factor (BDNF) | Within 48 hours of Neonatal Intensive Care Unit admission, at 4 months, 1 year and 2 years | 
| Change in serum neurotrophins with respiratory outcomes in children | Neurotrophins include Nerve Growth Factor (NGF) and Brain-factor Neurotrophic Factor (BDNF) | Within 48 hours of Neonatal Intensive Care Unit admission, at 4 months, 1 year and 2 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Biomarkers, Neurotrophins