Introduction
BRONCHOPULMONARY DYSPLASIA (BPD), CHRONIC LUNG DISEASE OF PREMATURITY, PULMONARY HYPERTENSION, PREMATURE, PULMONARY HYPERTENSION
Premature infants with chronic lung disease of prematurity, bronchopulmonary dysplasia (BPD), are at risk of developing pulmonary hypertension (PH) [Research efforts are needed to develop and evaluate therapies to improve outcomes for infants with BPD-PH. In 2022, the Pediatric Pulmonary Hypertension Network (PPHNet) noted the remarkable contribution of BPD-PH to the spectrum of pediatric PH and highlighted the need for focused research and randomized clinical trials (RCTs) in this understudied group of patients [Nitric oxide (NO) is a potent pulmonary vasodilator that can be administered exogenously as inhaled NO (iNO) gas. Oral/enteral supplementation with the NO-L-arginine precursor, L-citrulline, provides a way to increase endogenous NO as a potential treatment for PH [Our overarching goal is to evaluate orally/enterally administered L-citrulline as a potential treatment for BPD-PH. As a first step, we recently published data from a phase I study that characterized the PK profile of a single dose of enterally administered L-citrulline in premature infants at risk of developing BPD-PH to derive optimal dosage strategies using simulation-based methodology [