Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress

Bronchopulmonary dysplasia (BPD) remains a significant complication of preterm birth, characterized by impaired alveolar and vascular development, chronic lung inflammation, and long-term respiratory morbidity. Corticosteroids, both systemic and inhaled, have been widely investigated as potential th...

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Main Authors: Francesca Galletta, Alessandra Li Pomi, Sara Manti, Eloisa Gitto
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Antioxidants
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Online Access:https://www.mdpi.com/2076-3921/14/7/869
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author Francesca Galletta
Alessandra Li Pomi
Sara Manti
Eloisa Gitto
author_facet Francesca Galletta
Alessandra Li Pomi
Sara Manti
Eloisa Gitto
author_sort Francesca Galletta
collection DOAJ
description Bronchopulmonary dysplasia (BPD) remains a significant complication of preterm birth, characterized by impaired alveolar and vascular development, chronic lung inflammation, and long-term respiratory morbidity. Corticosteroids, both systemic and inhaled, have been widely investigated as potential therapeutic agents due to their anti-inflammatory properties and their emerging role in modulating oxidative stress. This narrative review explores the current evidence regarding the use of inhaled and systemic corticosteroids in the prevention and management of BPD, analyzing their efficacy, safety profiles, and long-term outcomes. While systemic corticosteroids, particularly dexamethasone, have demonstrated benefits in reducing ventilator dependence and lung inflammation, concerns regarding adverse neurodevelopmental effects have limited their routine use. Inhaled steroids have been proposed as a safer alternative, but their role in altering the disease trajectory remains controversial. A better understanding of the optimal timing, dosage, and patient selection is essential to maximize benefits while minimizing risks. Future research should focus on optimizing dosing strategies and identifying subgroups of preterm infants who may derive the greatest benefit from corticosteroid therapy.
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series Antioxidants
spelling doaj-art-11a91e8b69754e03b5db687e7ffbbaf62025-08-20T03:55:52ZengMDPI AGAntioxidants2076-39212025-07-0114786910.3390/antiox14070869Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative StressFrancesca Galletta0Alessandra Li Pomi1Sara Manti2Eloisa Gitto3Pediatric Unit, Department of Human Pathology in Adult and Developmental Age ‘Gaetano Barresi’, University of Messina, 98124 Messina, ItalyNeonatal and Pediatric Intensive Care Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyPediatric Unit, Department of Human Pathology in Adult and Developmental Age ‘Gaetano Barresi’, University of Messina, 98124 Messina, ItalyNeonatal and Pediatric Intensive Care Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyBronchopulmonary dysplasia (BPD) remains a significant complication of preterm birth, characterized by impaired alveolar and vascular development, chronic lung inflammation, and long-term respiratory morbidity. Corticosteroids, both systemic and inhaled, have been widely investigated as potential therapeutic agents due to their anti-inflammatory properties and their emerging role in modulating oxidative stress. This narrative review explores the current evidence regarding the use of inhaled and systemic corticosteroids in the prevention and management of BPD, analyzing their efficacy, safety profiles, and long-term outcomes. While systemic corticosteroids, particularly dexamethasone, have demonstrated benefits in reducing ventilator dependence and lung inflammation, concerns regarding adverse neurodevelopmental effects have limited their routine use. Inhaled steroids have been proposed as a safer alternative, but their role in altering the disease trajectory remains controversial. A better understanding of the optimal timing, dosage, and patient selection is essential to maximize benefits while minimizing risks. Future research should focus on optimizing dosing strategies and identifying subgroups of preterm infants who may derive the greatest benefit from corticosteroid therapy.https://www.mdpi.com/2076-3921/14/7/869bronchopulmonary dysplasiasystemic steroidsinhaled steroidslung injuryinflammationoxidative stress
spellingShingle Francesca Galletta
Alessandra Li Pomi
Sara Manti
Eloisa Gitto
Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress
Antioxidants
bronchopulmonary dysplasia
systemic steroids
inhaled steroids
lung injury
inflammation
oxidative stress
title Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress
title_full Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress
title_fullStr Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress
title_full_unstemmed Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress
title_short Inhaled and Systemic Steroids for Bronchopulmonary Dysplasia: Targeting Inflammation and Oxidative Stress
title_sort inhaled and systemic steroids for bronchopulmonary dysplasia targeting inflammation and oxidative stress
topic bronchopulmonary dysplasia
systemic steroids
inhaled steroids
lung injury
inflammation
oxidative stress
url https://www.mdpi.com/2076-3921/14/7/869
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AT saramanti inhaledandsystemicsteroidsforbronchopulmonarydysplasiatargetinginflammationandoxidativestress
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