{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T04:05:52Z","timestamp":1774670752398,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Council Impact Accelaration Award","award":["MR\/X502923\/1"],"award-info":[{"award-number":["MR\/X502923\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Worldwide, three-quarters of a million babies are born extremely preterm (&lt;28 weeks gestation) with devastating outcomes: 20% die in the newborn period, a further 35% develop bronchopulmonary dysplasia (BPD), and 10% suffer from cerebral palsy. Pioglitazone, a Peroxisome Proliferator Activated Receptor Gamma (PPAR\u03b3) agonist, may reduce the incidence of BPD and improve neurodevelopment in extreme preterm babies. Pioglitazone exerts an anti-inflammatory action mediated through Nuclear Factor-kappa B repression. PPAR\u03b3 signalling is underactive in preterm babies as adiponectin remains low during the neonatal period. In newborn animal models, pioglitazone has been shown to be protective against BPD, necrotising enterocolitis, and lipopolysaccharide-induced brain injury. Single Nucleotide Polymorphisms of PPAR\u03b3 are associated with inhibited preterm brain development and impaired neurodevelopment. Pioglitazone was well tolerated by the foetus in reproductive toxicology experiments. Bladder cancer, bone fractures, and macular oedema, seen rarely in adults, may be avoided with a short treatment course. The other effects of pioglitazone, including improved glycaemic control and lipid metabolism, may provide added benefit in the context of prematurity. Currently, there is no formulation of pioglitazone suitable for administration to preterm babies. A liquid formulation of pioglitazone needs to be developed before clinical trials. The potential benefits are likely to outweigh any anticipated safety concerns.<\/jats:p>","DOI":"10.3390\/ph16111530","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T09:42:52Z","timestamp":1698399772000},"page":"1530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["PPAR Gamma Receptor: A Novel Target to Improve Morbidity in Preterm Babies"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5314-7626","authenticated-orcid":false,"given":"Suresh","family":"Victor","sequence":"first","affiliation":[{"name":"Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King\u2019s College London, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8193-6107","authenticated-orcid":false,"given":"Ben","family":"Forbes","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Science, King\u2019s College London, Franklin-Wilkins Building, Stamford Street, London SE1 9NH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8672-5349","authenticated-orcid":false,"given":"Anne","family":"Greenough","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, School of Life Course and Population Sciences, King\u2019s College London, Neonatal Intensive Care Centre, Floor 4, Golden Jubilee Wing, King\u2019s College Hospital, Denmark Hill, Brixton, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-7066","authenticated-orcid":false,"given":"A. David","family":"Edwards","sequence":"additional","affiliation":[{"name":"Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King\u2019s College London, St. Thomas\u2019 Hospital, London SE1 7EH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, Regional, and Worldwide Estimates of Preterm Birth Rates in the Year 2010 with Time Trends since 1990 for Selected Countries: A Systematic Analysis and Implications","volume":"379","author":"Blencowe","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sinha, I.P., Bhatt, J.M., and Cleator, A. (2021). 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