{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:08:31Z","timestamp":1790017711928,"version":"4.0.1"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"OHB Neonatology Ltd to the University of Utah"},{"name":"Division of Neonatology at the University of Utah"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Bronchopulmonary dysplasia is associated with low concentrations of insulin-like growth factor 1 (IGF-1) protein in preterm infants. Postnatal replenishment of IGF-1 protein is a potential approach to prevent the decline in preterm human infants. Our recent 3-day pilot study in mechanically ventilated preterm lambs (131 days\u2019 gestation; n\u2009=\u20096) demonstrated downstream signaling of human IGF-1 in sheep cells in vitro and that 1.5\u2009mg\/kg\/d of recombinant human (rh) IGF-1 bound to binding protein 3 (IGFBP3; rhIGF-1 complex) delivered by continuous intravenous infusion provided physiological replacement of IGF-1 protein in plasma and suggested better pulmonary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed a longer period (7 days) of continuous treatment and larger sample size (10\/group), using younger mechanically ventilated preterm lambs (128 days\u2019 gestation; equivalent to human lung development at \u223c28 weeks\u2019 gestation) to allow evidence of preservation of respiratory gas exchange, alveolar formation and capillary growth, lung mechanics, and terminal bronchiole smooth muscle abundance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Preterm lambs were mechanically ventilated for 7 days. Lambs were randomized to blinded treatment with continuous intravenous infusion of either saline (vehicle control; 5 female\/5 male) or rhIGF-1 complex (5 female\/5 male), starting at 6\u2009hours after operative delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>RhIGF-1 complex significantly improved indices of respiratory gas exchange, alveolar formation, alveolar capillary growth, and VEGF-R2 messenger RNA expression, without adverse effects on liver or kidney function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RhIGF-1 complex may be an effective and safe therapy to promote functional and structural development underlying lung maturation in preterm infants and reduce the risk of developing bronchopulmonary dysplasia.<\/jats:p>\n     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