{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:54:25Z","timestamp":1791294865099,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371707 to CY"],"award-info":[{"award-number":["82371707 to CY"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzhen","doi-asserted-by":"publisher","award":["SZSM202211001"],"award-info":[{"award-number":["SZSM202211001"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study investigates the mediating role of inflammatory cytokines in the protective effect of human milk against bronchopulmonary dysplasia (BPD) in preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study included 73 infants born at &lt;\u200928 weeks' gestation.Infants were classified into high\u2010dose human milk and high\u2010dose formula groups according to feeding patterns at 36 weeks postmenstrual age (PMA). Cross\u2010sectional group comparisons of inflammatory factors at postnatal day 7, day 28, and PMA 36 weeks were examined by Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test, while longitudinal changes in plasma inflammatory cytokines were evaluated using generalized estimating equations (GEE), and mediation analysis was performed using PROCESS version 4 to assess the potential indirect effects of inflammatory cytokines on the association between human milk exposure and BPD severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Infants in the high\u2010dose human milk group had a significantly lower incidence of grade II\/III BPD and lower plasma concentrations of CXCL10, IL\u20101Ra, and IL\u201013 at 36 weeks PMA than those in the high\u2010dose formula group. Longitudinal GEE analysis showed significant temporal changes in these cytokines but no significant group \u00d7 time interactions. Mediation analysis demonstrated a significant joint indirect effect through IL\u20101Ra and CXCL10 (effect\u2009=\u2009\u22120.245, 95% CI\u2009\u22120.487 to \u22120.046), accounting for 34.9% of the total association between human milk exposure and BPD severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High human milk feeding was associated with lower BPD severity and a less activated inflammatory profile at 36 weeks PMA. IL\u20101Ra\u2010 and CXCL10\u2010related inflammatory pathways may partially account for this association, although the observational design precludes definitive causal inference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71836","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:50:38Z","timestamp":1789649438000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Human Milk and Bronchopulmonary Dysplasia in Preterm Infants: The Mediation of Inflammatory Cytokines"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4985-9452","authenticated-orcid":false,"given":"Yunbei","family":"Rao","sequence":"first","affiliation":[{"name":"Shenzhen Maternity and Child Healthcare Hospital, Women and Children's Medical Center Southern Medical University Shen Zhen Guangdong China"},{"name":"Shenzhen School of Clinical Medicine Southern 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