Roberta Ballard, MD and Eric Gibson, MD

In this segment, “iNO and Race in the Prevention of BPD in the Preterm Infant,” Dr. Ballard and Dr. Gibson deliberate the role of race in the response to inhaled nitric oxide (iNO) therapy to prevent bronchopulmonary dysplasia (BPD).

The utility of iNO in the treatment of BPD in premature infants has repeatedly been questioned. Dr. Ballard’s group recently completed a clinical trial to investigate the role of higher than conventional doses of iNO to prevent BPD. These higher doses of iNO successfully lowered BPD rates in black male neonates, a finding which has been corroborated by other investigators whose study populations included a similar racial makeup. This association was persistent regardless of whether the neonates were identified as black by parental self-report or whether ancestry was confirmed with genomic studies. A possibility therefore exists that on a basic DNA level there may be some differences between races in terms of disease manifestation, which could suggest there may be some benefit in providing racially targeted therapies. Further randomized trials are needed to validate this, particularly as BPD is a heavily multifaceted condition with a likely convoluted model of disease.

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