Orphan drugs in bronchopulmonary dysplasia

Introduction: Bronchopulmonary dysplasia (BPD) is a common adverse outcome of very premature birth. It has a multifactorial aetiology which includes oxygen toxicity. In this review the potential of antioxidants to reduce BPD is explored. Areas covered: The aim of the review is to determine the potential of agents which reduce oxygen toxicity to prevent BPD development. A literature review was undertaken using PubMed using the terms: BPD, prevention of BPD, antioxidants, superoxide dismutase (SOD), N-acetyl cysteine, allopurinol, melatonin, cimetidine, alpha-1-protease inhibitor, pentoxifylline and macrolides. Expert opinion: There are several therapies which reduce oxygen toxicity that have shown promising results with regard to improving the respiratory outcome of prematurely born infants. However, further work is necessary to identify the optimum antioxidant which reduces BPD and improves long-term respiratory outcome.