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Oxidative Medicine and Cellular Longevity
Volume 2014, Article ID 721043, 10 pages
http://dx.doi.org/10.1155/2014/721043
Review Article

Antioxidant Strategies and Respiratory Disease of the Preterm Newborn: An Update

1Neonatal Intensive Care Unit, Careggi University Hospital, 3 Largo Brambilla, 50141 Florence, Italy
2Section of Neonatology, Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, 3 Largo Brambilla, 50141 Florence, Italy

Received 10 January 2014; Accepted 6 March 2014; Published 7 April 2014

Academic Editor: Serafina Perrone

Copyright © 2014 Chiara Poggi and Carlo Dani. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Preterm newborns are challenged by an excessive oxidative burden, as a result of several perinatal stimuli, as intrauterine infections, resuscitation, mechanical ventilation, and postnatal complications, in the presence of immature antioxidant capacities. “Oxygen radical disease of neonatology” comprises a wide range of conditions sharing a common pathway of pathogenesis and includes bronchopulmonary dysplasia (BPD) and other main complications of prematurity. Antioxidant strategies may be beneficial in the prevention and treatment of oxidative stress- (OS-) related lung disease of the preterm newborn. Endotracheal supplementation or lung-targeted overexpression of superoxide dismutase was proved to reduce lung damage in several models; however, the supplementation in preterm newborn failed to reduce the risk of BPD, although long-term respiratory outcomes were improved. Also melatonin administration to small cohorts of preterm newborns suggested beneficial effects on lung OS. The possibility to identify single nucleotide polymorphism affecting the risk of BPD may help to identify specific populations with particularly high risk of OS-related diseases and may pose the basis for individually targeted treatments. Finally, surfactant replacement may lead to local anti-inflammatory and antioxidant effects, thanks to specific enzymatic and nonenzymatic antioxidants naturally present in animal surfactants.