Ciliary dynamics may play a role in the pathophysiology of bronchopulmonary dysplasia

Premature infants are at risk of bronchopulmonary dysplasia, or BPD, a type of lung injury associated with increased mortality. Now a new study published at the ATS 2025 International Conference shows that ciliary dynamics may play a role in the pathophysiology of this disease.

Researchers found that infants with more severe BPD showed signs of ciliary dysfunction that were not present in those with moderate disease. It's the first study to examine the link between BPD and cilia, tiny hairlike structures that help clear the airways of mucus and pathogens.

Ciliary dynamics have never really been studied before in BPD, and we found they can have a significant impact on the pathophysiology."

Daniel A. Yassa, MD, first author, pediatric pulmonologist at UT Health Houston

BPD is a type of chronic lung injury that can occur in premature infants as a result of barotrauma and oxygen injury. Existing therapies focus on protecting the functional tissues of the lungs, airway management, and managing vascular complications. However, the impact of ciliary function and the ability of cilia to clear mucus hasn't been understood.

Cilia work by "beating," or moving in coordinated pulses to propel mucus out of the body. Dysfunctional mucociliary clearance is known to be linked to recurrent infections and progressive lung damage, Dr. Yassa noted.

For the new, retrospective study, researchers used high-speed video microscopy to observe nasal samples from nine infants with BPD, analyzing four recordings for each patient. The team found a distinct reduction in the angle and amplitude of cilia beats in patients with severe BPD, compared to those with more moderate disease.

The findings provide new insights into the mechanisms that influence BPD severity and point to a potential role of mucociliary clearance in the development of the disease, Dr. Yassa said.

"This potentially allows us to have a better understanding of the disease process, which can affect all aspects of clinical care," he said. The findings could potentially point to new therapeutic targets, help classify BPD diagnoses, or lead to other advances in managing BPD.

Next, the researchers hope to continue with follow-up studies.

"Future research with larger cohorts and advanced imaging modalities is warranted to further elucidate the implications of ciliary dynamics and physical properties on clinical outcomes in patients with BPD," he added.