The following is a summary of “Hemosiderin-Laden Macrophages in Bronchoalveolar Lavage Samples of Children with Bronchopulmonary Dysplasia,” published in the FEBRUARY 2023 issue of Pediatrics by Franklin, et al.

For a study, researchers sought to evaluate the prevalence of hemosiderin-laden macrophages in children with bronchopulmonary dysplasia (BPD) and to assess for an association between hemosiderin-laden macrophages and pulmonary arterial hypertension.

The study design was a retrospective case-control study of infants and children with and without BPD who underwent bronchoscopy with bronchoalveolar lavage (BAL) at Children’s Hospital of Philadelphia between 2012 and 2021.

The study reviewed BAL from 205 children with BPD and 106 controls without BPD who were matched for tracheostomy, infection, and age. Results showed that 71 individuals (34.6%) with BPD had a BAL with 10% or more hemosiderin-laden macrophages compared with 3 (2.8%) controls (P < .0001; OR, 18.19; 95% CI, 5.57-59.41). Patients with pulmonary hypertension by an echocardiogram (P = .04; OR, 3.69; 95% CI, 1.05-12.96) or an elevated mean pulmonary artery pressure during cardiac catheterization, rs (14) = 0.56, P = .04 were more likely to have elevated hemosiderin-laden macrophages on BAL samples less than 60 days from bronchoscopy. After adjusting for birth weight, gestational age, BPD grade, and age at the time of bronchoscopy using logistic regression, pulmonary hypertension was associated with higher odds of hemosiderin-laden macrophages of 10% or more (P = .02; OR, 6.37; 95% CI, 1.28-31.87). No association was observed between hemosiderin-laden macrophages and sex, race, gestational age, birth weight, tracheostomy, or infectious studies.

The study found increased hemosiderin-laden macrophages in BAL samples from patients with BPD and a significant association with pulmonary arterial hypertension. The contribution of elevated hemosiderin-laden macrophages to the pathogenesis of lung and pulmonary vascular disease in BPD remained unclear, but it may be a biomarker of pulmonary arterial hypertension.

Reference: jpeds.com/article/S0022-3476(22)00823-X/fulltext