Which factor plays a major role in the pathogenesis of bronchopulmonary dysplasia?

• A. Non-invasive respiratory support modalities
• B. Permissive hypercapnia
• C. Inflammatory response (correct)
• D. Pulmonary edema

Answer: (C)

Inflammatory response plays a major role in the pathogenesis of bronchopulmonary dysplasia. In preterm lungs, exposure to oxygen, mechanical ventilation, infections, and other stressors triggers a robust inflammatory cascade with cytokines and chemokines attracting neutrophils and macrophages, generating reactive oxygen species, and causing ongoing injury to developing airways and alveoli. This inflammatory injury disrupts normal alveolar septation and vascular development, leading to the simplified, fibrotic lung architecture characteristic of BPD. While other factors like ventilation methods or edema can influence severity and outcomes, the core driver of the chronic lung changes in BPD is the inflammatory injury that interferes with normal lung growth and remodeling.