247 - Bronchopulmonary dysplasia in preterm infants associated with hypoargininemia

Publication Number: 247.4552

Areeba Makhdoom, McGovern Medical School at the University of Texas Health Science Center at Houston, houston, TX, United States; Zainab Manan, University of Texas Medical Branch School of Medicine, Galveston, TX, United States; Sunil Jain, University of Texas Medical Branch School of Medicine, Galveston, TX, United States

Background: Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in preterm infants with a multifactorial etiology. Nitric oxide, a potent vasodilator may be linked to this condition and is produced utilizing arginine as a substrate. We wanted to explore if preterm infants have arginine deficiency and if there is an association between hypoargininemia and BPD.

Objective: To explore if preterm infants have hypoargininemia and the association between hypoargininemia and BPD.

Design/Methods: After IRB approval, we conducted a prospective cross-sectional observational pilot study. We collected blood at 36 weeks CGA from 31 neonates born at < 32 weeks gestation at the UTMB NICU from September 2022 to October 2023. Plasma levels of arginine and citrulline were measured using mass spectrometer. Neonatal and maternal clinical data was also collected from electronic medical record. BPD was defined as having an oxygen requirement at 36 weeks CGA and hypoargininemia as plasma level of < 25 µmol/L. Data was analyzed using SPSS version 21. Demographic data and maternal risk factors were assessed. A p value of < 0.05 was significant.

Results: All preterm infants had hypoargininemia. Mean arginine level calculated for all preterm infants was 17.01 (SD 5.41). Mean arginine levels were significantly lower in infants with BPD (14.14 vs 22.24 μmol/L P < 0.05). No statistically significant difference was observed in plasma citrulline levels between the groups.

Conclusion(s): Preterm infants have hypoargininemia and infants with BPD have even lower arginine levels. Arginine supplementation may be a potential precursor of nitric oxide which may modify respiratory outcome in preterm infants. This association requires further confirmation.

Argnine and citrulline concentrations in BPD vs without BPD infants