Very preterm birth represent about 1% of livebirths in Europe each year and is associated with 58% of neonatal deaths and substantial lifetime health problems. Pneumocystis jirovecii is an ubiquitous microfungus commonly known for causing a severe interstitial pneumonia in immunosuppressed subjects. However, this could be the tip of the iceberg and compelling new evidences suggest that this infection may be pathogenic to certain groups of infants. In utero transmission of P. jirovecii in humans has been recently proven. The fungus has been found in the lungs of 14-25% preterm newborns, associated with an increased risk of respiratory distress syndrome (RDS) and bronchopulmonary dysplasia. The ability of P. jirovecii to change the pulmonary environment has been demonstrated in other contexts, inducing a modification of the host immune response, pulmonary dysbiosis and thickening of pulmonary alveoli. Genetic polymorphisms have also been independently implicated in both an increased risk of preterm bi or neonatal RDS and a susceptibility to P. jirovecii.
Hence, JIROborn aims to address the impact of P. jirovecii in utero infection on the preterm infants’ lungs alteration and on the development of subsequent early or late diseases, constructing a predictive model for monitoring preterm infants’ related pulmonary complications. This project is structured around 4 specific objectives (SO):
- To determine epidemiologically the early and late clinical impact of Pj in utero transmission on the preterm pulmonary complications and potential associated risk factors.
- To evaluate the biological impact of Pj in utero infection, in case of lung disease or not, on the local pulmonary inflammation, surfactant and mucus lungs production and lungs microbiota.
- To identify genetic or epigenetic susceptibilities in mothers and newborns related to the risk of colonization by Pj and/ or to the development of pulmonary diseases.
- To build a predictive model for the respiratory monitoring of VPT infants infected by Pj in utero.
