Immune modulators for the therapy of BPD

An excessive and/or persistent inflammatory response makes a significant contribution to the pathogenesis of bronchopulmonary dysplasia in preterm infants. Suppression of inflammation with post-natal steroids is associated with several unwanted side-effects and novel immunomodulatory strategies are therefore required. In this chapter we will outline the potential of three different tactics for immunomodulation: modulation of signaling pathways regulated by macrophage migration inhibitory factor (MIF), targeting interleukin (IL)-1β mediated pro-inflammatory pathways and use of recombinant forms of the innate host defense molecule, surfactant protein D. The relevance of these pathways to neonatal lung disease and the results of both clinical and laboratory studies involving experimental models of BPD will be discussed in detail.