ORIGINAL RESEARCH article

Front. Pediatr.

Sec. Pediatric Pulmonology

Volume 13 - 2025 | doi: 10.3389/fped.2025.1578628

Analysis and validation of necroptosis-related diagnostic biomarkers associated with immune infiltration in Bronchopulmonary Dysplasia

Provisionally accepted
Haixia  TuHaixia Tu1Changjiang  FangChangjiang Fang2Ping  GanPing Gan1Yunyun  GuYunyun Gu1Nana  PengNana Peng1Honghua  JiangHonghua Jiang1Weiwei  HouWeiwei Hou1*Guihua  ShuGuihua Shu3*
  • 1Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, Jiangsu Province, China
  • 2The First People's Hospital of Kunshan, Suzhou, China
  • 3Yangzhou Maternity and Child Health Care Hospital, Yangzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common serious complication in very preterm infants. This study aims to identify necroptosis-related genes (NRGs) and analyze the relationship between necroptosis-related diagnostic markers and immune infiltration in BPD.We obtained the dataset GSE32472 from the GEO database and analyzed the differentially expressed NRGs (DE-NRGs). We identified the biological functions and pathways of DE-NRGs. RF (random forest) and LASSO (least absolute shrinkage and selection operator) algorithms were applied to identify hub genes. We explored the immune landscape of BPD and controls by CIBERSORT. The correlations between hub genes and immune cells were evaluated using Spearman correlation analysis. ELISA was used to verify the diagnostic value of hub genes in patients with BPD in our hospital.RESULTS: 27 DE-NRGs were screened. We found the primary biological functions and pathways of DE-NRGs, including necroptosis, and regulation of inflammatory response. Three hub genes (PELI1, PYGL, and STAT4) were identified and utilized to construct a diagnostic nomogram. The AUC value of the nomogram was greater than 0.7 in the validation dataset GSE188944. CIBERSORT showed that the proportions of 6 different immune cell types in the BPD group were higher or lower than the control group (P<0.05). Correlation analysis showed that three hub genes may correlate with immune cells to varying degrees. Serum ELISA results of PELI1 and PYGL showed no significant difference between BPD and Controls (P>0.05), the expression level of STAT4 was downregulated in BPD samples (P<0.05), and the AUC value of the STAT4 was higher than 0.7.The necroptosis-related gene STAT4 can be a diagnostic marker of BPD patients. The necroptosis-related gene and immune infiltration may be related to the progression of BPD.

Keywords: Bronchopulmonary Dysplasia, necroptosis, diagnostic biomarkers, Immune infiltration, preterm infants

Received: 18 Feb 2025; Accepted: 24 Jun 2025.

Copyright: © 2025 Tu, Fang, Gan, Gu, Peng, Jiang, Hou and Shu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Weiwei Hou, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, 225001, Jiangsu Province, China
Guihua Shu, Yangzhou Maternity and Child Health Care Hospital, Yangzhou, Jiangsu Province, China

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