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Neal, Charles Jr. MD, PhD

HEALTH Initiative Leader - Perinatal, Growth, and Development
Pilot Project Co-PI
Emerging Investigator - Perinatal, Growth, and Development
Associate Professor, Department of Pediatrics
John A. Burns School of Medicine

808.983.8387
cneal@kapiolani.org




Research Overview

2011-2012 RMATRIX Collaboration Pilot Projects Program Awards

Project Description

Title: Effect of Corticosteroids on Pulmonary Surfactant of Premature Newborns
Principal Investigator: Yi Zuo, PhD, Dept. of Mechanical Engineering, UH College of Engineering
Co-Principal Investigator: Charles R. Neal, Jr., MD, PhD, Dept. of Pediatrics, UH JABSOM
RMATRIX HEALTH Initiative(s): Respiratory Health, Perinatal, Growth & Developmental Health
RMATRIX Key Function Support: Participant & Clinical Resources Support, Research Design & Biostatistics Support
RMATRIX Funding: $29,257
External Link:

Abstract

Effect of Corticosteroids on Pulmonary Surfactant of Premature Newborns

Chronic lung disease (CLD), also known as bronchopulmonary dysplasia, is a common complication of premature birth. Premature birth in Hawaii has shown distinct ethnic disparities, with a significantly higher incidence for Native Hawaiians and Asians. Due to concerns of adverse neurodevelopmental outcomes associated with systemic administration of corticosteroids in treatment of premature newborns with or at high risk for CLD, research validating the effectiveness of inhaled corticosteroids in reducing the incidence of CLD, and thereby increasing or standardizing their use, could reduce morbidity and mortality in this population. Despite the low risk-benefit ratio inhaled corticosteroids offer, it is still controversial whether inhaled corticosteroids can reduce the incidence of CLD. The mechanism by which the inhaled corticosteroids may confer respiratory benefit is still unclear and the clinical practice of inhaled corticosteroid therapy has not been standardized and optimized. The specific aims of this proposal are to (1) develop a practical clinical procedure of extracting pulmonary surfactant from tracheal aspirates of ventilated neonates with or at high risk for CLD and create a bank of pulmonary surfactant samples that reflects the ethnic disparity of premature birth in Hawaii; (2) conduct detailed biochemical and biophysical characterization of these newborn surfactant samples using an interdisciplinary approach and relate this knowledge to the potential pathophysiology of premature birth; and (3) study the mechanism of interaction between the newborn surfactant and corticosteroid drugs and translate this fundamental knowledge into clinical practice of improving efficacy and safety of inhaled corticosteroid therapy in prevention and management of CLD in premature newborns. The proposed study is expected to reveal the in vitro effect of corticosteroids on the pulmonary surfactant of premature newborns with an interdisciplinary approach. This fundamental research has the potential to be translated into clinical practice improving efficacy and safety of inhaled corticosteroid therapy in prevention and management of CLD in premature newborns. It also has implications to the study of inhalation therapy for treating asthma and COPD, and to the development of intratracheal administration of corticosteroids using exogenous surfactants as a delivering vehicle.



Selected Publications

  • Derauf C, Lagasse LL, Smith LM, Newman E, Shah R, Neal CR, Arria AM, Huestis MA, Dellagrotta S, Dansereau LM, Lin H, Lester BM.
    Prenatal methamphetamine exposure and inhibitory control among young school-age children.
    J Pediatr 2012 [more...]

  • Zhang H, Wang YE, Neal CR, Zuo YY.
    Differential effects of cholesterol and budesonide on biophysical properties of clinical surfactant.
    Pediatr Res 2012 [more...]

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Supported by a grant from the National Institute on Minority Health and Health Disparities (U54MD007584), National Institutes of Health.