The term endotype refers to ‘‘a subtype of a condition, which is defined by a distinct functional or pathophysiological mechanism’’. A phenotype describes the observable physical manifestations of a particular disease. Endotypes are thus a different form of classification from clinical phenotypes and describe distinct disease entities with a defining etiology and/or a consistent pathophysiological mechanism. Although, so far, no clear consensus exists on the endotypes of prematurity, the combination of clinical information with placental and microbiological data suggests the identification of two main pathways leading to very preterm birth: 1) infection/inflammation and 2) dysfunctional placentation. The first group includes chorioamnionitis, preterm labor and rupture of membranes, placental abruption, and cervical insufficiency. The second group includes hypertensive disorders of pregnancy and/or intrauterine growth restriction. Intrauterine habitat and the influence of external environment on the developing fetus varies greatly between the two endotypes of prematurity. Evidence is increasingly supporting the hypothesis that most of the complications of prematurity encompass different forms of organ injury (phenotypes), highly influenced by the different environment to which the developing organs are exposed in utero (endotypes).
It is a common understanding that the pathophysiological condition triggering preterm birth plays a major role in the clinical picture and the development of complications of prematurity. However, a persistent unanswered question is which part of these complications are due to prematurity per se and which part are due to the pathological changes induced by the endotype. Comparing how different pathological conditions affect the same outcome can provide insight into the relationship between endotype and phenotype. According to this view, the pathogenesis of complications of prematurity is multifactorial and heterogeneous. Different patterns of antenatal stress - or endotypes- combined with varying postnatal insults might distinctively affect the outcome. In line with the approach of personalized medicine, endotyping prematurity and phenotyping the complications of prematurity will facilitate the design of more targeted therapeutic and prognostic approaches. The objective of this research topic is to deepen the knowledge about the association between endotypes of prematurity and phenotypes of complications of prematurity.
This Research Topic will include studies focused on enlightening the link between the major endotypes of prematurity and the complications of preterm birth, with a particular interest to their different phenotypes. Complications of prematurity may include but are not limited to: necrotizing enterocolitis and other intestinal conditions, retinopathy of prematurity, acute and chronic lung disease, acute and chronic brain injury, cardiocirculatory adaptation at birth, and patent ductus arteriosus. We are also interested in studies investigating the relationship between the endotypes of prematurity and the long-term neurological and respiratory outcomes of former preterm infants. The possibility to decode the molecular and genetic pathways potentially involved is also highly appreciated.
The types of articles we are looking for include: case series, prospective or retrospective case-control studies, prospective or retrospective cohort studies, systematic reviews, randomized trials, narrative reviews, in vivo animal studies and in vitro studies.
The term endotype refers to ‘‘a subtype of a condition, which is defined by a distinct functional or pathophysiological mechanism’’. A phenotype describes the observable physical manifestations of a particular disease. Endotypes are thus a different form of classification from clinical phenotypes and describe distinct disease entities with a defining etiology and/or a consistent pathophysiological mechanism. Although, so far, no clear consensus exists on the endotypes of prematurity, the combination of clinical information with placental and microbiological data suggests the identification of two main pathways leading to very preterm birth: 1) infection/inflammation and 2) dysfunctional placentation. The first group includes chorioamnionitis, preterm labor and rupture of membranes, placental abruption, and cervical insufficiency. The second group includes hypertensive disorders of pregnancy and/or intrauterine growth restriction. Intrauterine habitat and the influence of external environment on the developing fetus varies greatly between the two endotypes of prematurity. Evidence is increasingly supporting the hypothesis that most of the complications of prematurity encompass different forms of organ injury (phenotypes), highly influenced by the different environment to which the developing organs are exposed in utero (endotypes).
It is a common understanding that the pathophysiological condition triggering preterm birth plays a major role in the clinical picture and the development of complications of prematurity. However, a persistent unanswered question is which part of these complications are due to prematurity per se and which part are due to the pathological changes induced by the endotype. Comparing how different pathological conditions affect the same outcome can provide insight into the relationship between endotype and phenotype. According to this view, the pathogenesis of complications of prematurity is multifactorial and heterogeneous. Different patterns of antenatal stress - or endotypes- combined with varying postnatal insults might distinctively affect the outcome. In line with the approach of personalized medicine, endotyping prematurity and phenotyping the complications of prematurity will facilitate the design of more targeted therapeutic and prognostic approaches. The objective of this research topic is to deepen the knowledge about the association between endotypes of prematurity and phenotypes of complications of prematurity.
This Research Topic will include studies focused on enlightening the link between the major endotypes of prematurity and the complications of preterm birth, with a particular interest to their different phenotypes. Complications of prematurity may include but are not limited to: necrotizing enterocolitis and other intestinal conditions, retinopathy of prematurity, acute and chronic lung disease, acute and chronic brain injury, cardiocirculatory adaptation at birth, and patent ductus arteriosus. We are also interested in studies investigating the relationship between the endotypes of prematurity and the long-term neurological and respiratory outcomes of former preterm infants. The possibility to decode the molecular and genetic pathways potentially involved is also highly appreciated.
The types of articles we are looking for include: case series, prospective or retrospective case-control studies, prospective or retrospective cohort studies, systematic reviews, randomized trials, narrative reviews, in vivo animal studies and in vitro studies.