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Dodson RB, Powers KN, Gien J, Rozance PJ, Seedorf G, Astling D, Jones K, Crombleholme TM, Abman SH, Alvira CM. Intrauterine growth restriction decreases NF-κB signaling in fetal pulmonary artery endothelial cells of fetal sheep. Am J Physiol Lung Cell Mol Physiol 2018; 315:L348-L359. [PMID: 29722560 DOI: 10.1152/ajplung.00052.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Intrauterine growth restriction (IUGR) in premature newborns increases the risk for bronchopulmonary dysplasia, a chronic lung disease characterized by disrupted pulmonary angiogenesis and alveolarization. We previously showed that experimental IUGR impairs angiogenesis; however, mechanisms that impair pulmonary artery endothelial cell (PAEC) function are uncertain. The NF-κB pathway promotes vascular growth in the developing mouse lung, and we hypothesized that IUGR disrupts NF-κB-regulated proangiogenic targets in fetal PAEC. PAECs were isolated from the lungs of control fetal sheep and sheep with experimental IUGR from an established model of chronic placental insufficiency. Microarray analysis identified suppression of NF-κB signaling and significant alterations in extracellular matrix (ECM) pathways in IUGR PAEC, including decreases in collagen 4α1 and laminin α4, components of the basement membrane and putative NF-κB targets. In comparison with controls, immunostaining of active NF-κB complexes, NF-κB-DNA binding, baseline expression of NF-κB subunits p65 and p50, and LPS-mediated inducible activation of NF-κB signaling were decreased in IUGR PAEC. Although pharmacological NF-κB inhibition did not affect angiogenic function in IUGR PAEC, angiogenic function of control PAEC was reduced to a similar degree as that observed in IUGR PAEC. These data identify reductions in endothelial NF-κB signaling as central to the disrupted angiogenesis observed in IUGR, likely by impairing both intrinsic PAEC angiogenic function and NF-κB-mediated regulation of ECM components necessary for vascular development. These data further suggest that strategies that preserve endothelial NF-κB activation may be useful in lung diseases marked by disrupted angiogenesis such as IUGR.
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Affiliation(s)
- R Blair Dodson
- Laboratory for Fetal and Regenerative Biology, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Pediatric Heart Lung Center, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Surgery, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,United Therapeutics, Regenerative Medicine Laboratory, Research Triangle Park, Durham, North Carolina
| | - Kyle N Powers
- Laboratory for Fetal and Regenerative Biology, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Pediatric Heart Lung Center, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Surgery, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - Jason Gien
- Pediatric Heart Lung Center, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - Paul J Rozance
- Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - Gregory Seedorf
- Pediatric Heart Lung Center, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Biochemistry and Molecular Genetics, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - David Astling
- United Therapeutics, Regenerative Medicine Laboratory, Research Triangle Park, Durham, North Carolina
| | - Kenneth Jones
- United Therapeutics, Regenerative Medicine Laboratory, Research Triangle Park, Durham, North Carolina
| | - Timothy M Crombleholme
- Laboratory for Fetal and Regenerative Biology, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Surgery, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - Steven H Abman
- Pediatric Heart Lung Center, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado.,Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus , Aurora, Colorado
| | - Cristina M Alvira
- Department of Pediatrics, Stanford University School of Medicine , Palo Alto, California
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Orgeig S, Morrison JL, Daniels CB. Evolution, Development, and Function of the Pulmonary Surfactant System in Normal and Perturbed Environments. Compr Physiol 2015; 6:363-422. [PMID: 26756637 DOI: 10.1002/cphy.c150003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Surfactant lipids and proteins form a surface active film at the air-liquid interface of internal gas exchange organs, including swim bladders and lungs. The system is uniquely positioned to meet both the physical challenges associated with a dynamically changing internal air-liquid interface, and the environmental challenges associated with the foreign pathogens and particles to which the internal surface is exposed. Lungs range from simple, transparent, bag-like units to complex, multilobed, compartmentalized structures. Despite this anatomical variability, the surfactant system is remarkably conserved. Here, we discuss the evolutionary origin of the surfactant system, which likely predates lungs. We describe the evolution of surfactant structure and function in invertebrates and vertebrates. We focus on changes in lipid and protein composition and surfactant function from its antiadhesive and innate immune to its alveolar stability and structural integrity functions. We discuss the biochemical, hormonal, autonomic, and mechanical factors that regulate normal surfactant secretion in mature animals. We present an analysis of the ontogeny of surfactant development among the vertebrates and the contribution of different regulatory mechanisms that control this development. We also discuss environmental (oxygen), hormonal and biochemical (glucocorticoids and glucose) and pollutant (maternal smoking, alcohol, and common "recreational" drugs) effects that impact surfactant development. On the adult surfactant system, we focus on environmental variables including temperature, pressure, and hypoxia that have shaped its evolution and we discuss the resultant biochemical, biophysical, and cellular adaptations. Finally, we discuss the effect of major modern gaseous and particulate pollutants on the lung and surfactant system.
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Affiliation(s)
- Sandra Orgeig
- School of Pharmacy & Medical Sciences and Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Janna L Morrison
- School of Pharmacy & Medical Sciences and Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Christopher B Daniels
- School of Pharmacy & Medical Sciences and Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
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3
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Briana DD, Malamitsi-Puchner A. Small for gestational age birth weight: impact on lung structure and function. Paediatr Respir Rev 2013; 14:256-62. [PMID: 23249620 DOI: 10.1016/j.prrv.2012.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 09/18/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
Abstract
Accumulating data suggest that prenatal compromises leading to intrauterine growth restriction (IUGR) increase the risk for respiratory deficiencies after birth. In this respect, a growing body of epidemiological evidence in infants, children and adults indicates that small for gestational (SGA) birth weight can adversely affect lung function, thus questioning the widely accepted concept that IUGR accelerates lung maturation and improves outcome. Although the mechanisms responsible for the relationship between SGA and later lung dysfunction remain poorly documented, animal data indicate that intrauterine lung development can be adversely affected by factors associated with IUGR, namely reduced substrate supply, fetal hypoxemia and hypercortisolemia. Thus, it is suggested that fetal adaptations to intrauterine undernutrition result in permanent changes in lung structure, which in turn lead to chronic airflow obstruction. The purpose of this review is to describe and discuss the effects of IUGR on lung structure and function.
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Affiliation(s)
- Despina D Briana
- Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece
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4
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Molecular and Physiological Determinants of Pulmonary Developmental Biology: a Review. ACTA ACUST UNITED AC 2013. [DOI: 10.12691/ajbr-1-1-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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5
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Pike K, Jane Pillow J, Lucas JS. Long term respiratory consequences of intrauterine growth restriction. Semin Fetal Neonatal Med 2012; 17:92-8. [PMID: 22277109 DOI: 10.1016/j.siny.2012.01.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Epidemiological studies demonstrate that in-utero growth restriction and low birth weight are associated with impaired lung function and increased respiratory morbidity from infancy, throughout childhood and into adulthood. Chronic restriction of nutrients and/or oxygen during late pregnancy causes abnormalities in the airways and lungs of offspring, including smaller numbers of enlarged alveoli with thicker septal walls and basement membranes. The structural abnormalities and impaired lung function seen soon after birth persist or even progress with age. These changes are likely to cause lung symptomology through life and hasten lung aging.
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Affiliation(s)
- Katharine Pike
- Clinical and Experimental Medicine Academic Unit, University of Southampton, UK
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6
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Rehan VK, Sakurai R, Li Y, Karadag A, Corral J, Bellusci S, Xue YY, Belperio J, Torday JS. Effects of maternal food restriction on offspring lung extracellular matrix deposition and long term pulmonary function in an experimental rat model. Pediatr Pulmonol 2012; 47:162-71. [PMID: 22058072 PMCID: PMC3258334 DOI: 10.1002/ppul.21532] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 07/17/2011] [Indexed: 12/26/2022]
Abstract
Intrauterine growth restriction (IUGR) increases the risk of respiratory compromise throughout postnatal life. However, the molecular mechanism(s) underlying the respiratory compromise in offspring following IUGR is not known. We hypothesized that IUGR following maternal food restriction (MFR) would affect extracellular matrix deposition in the lung, explaining the long-term impairment in pulmonary function in the IUGR offspring. Using a well-established rat model of MFR during gestation to produce IUGR pups, we found that at postnatal day 21, and at 9 months (9M) of age the expression and abundance of elastin and alpha smooth muscle actin (αSMA), two key extracellular matrix proteins, were increased in IUGR lungs when compared to controls (P < 0.05, n = 6), as determined by both Western and immunohistochemistry analyses. Compared to controls, the MFR group showed no significant change in pulmonary resistance at baseline, but did have significantly decreased pulmonary compliance at 9M (P < 0.05 vs. control, n = 5). In addition, MFR lungs exhibited increased responsiveness to methacholine challenge. Furthermore, exposing cultured fetal rat lung fibroblasts to serum deprivation increased the expression of elastin and elastin-related genes, which was blocked by serum albumin supplementation, suggesting protein deficiency as the predominant mechanism for increased pulmonary elastin deposition in IUGR lungs. We conclude that accompanying the changes in lung function, consistent with bronchial hyperresponsiveness, expression of the key alveolar extracellular matrix proteins elastin and αSMA increased in the IUGR lung, thus providing a potential explanation for the compromised lung function in IUGR offspring.
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Affiliation(s)
- Virender K Rehan
- Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute at Harbor-UCLA, David Geffen School of Medicine at UCLA, Torrance, California, USA.
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Jeong Y, Jung-Choi K, Lee JH, Lee HY, Park EA, Kim YJ, Ha E, Oh SY, Park H. Body weight at birth and at age three and respiratory illness in preschool children. J Prev Med Public Health 2011; 43:369-76. [PMID: 20959707 DOI: 10.3961/jpmph.2010.43.5.369] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. METHODS The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. RESULTS Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). CONCLUSIONS Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.
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Affiliation(s)
- Yoolwon Jeong
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Korea
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8
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Karadag A, Sakurai R, Wang Y, Guo P, Desai M, Ross MG, Torday JS, Rehan VK. Effect of maternal food restriction on fetal rat lung lipid differentiation program. Pediatr Pulmonol 2009; 44:635-44. [PMID: 19514059 PMCID: PMC2919756 DOI: 10.1002/ppul.21030] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although "fetal programming" has been extensively studied in many organs, there is only limited information on pulmonary effects in the offspring following intrauterine growth restriction (IUGR). We aimed to determine the effects of nutrient restriction on the lung structure and lung lipid differentiation programs in offspring using an animal mode of maternal food restriction (MFR). We utilized a rodent model of 50% MFR from day 10 of gestation to term and then using lung morphology, Western blotting, Real Time RT-PCR and Oil Red O staining, lung structure and development of the offspring were examined at postnatal days (p) 1, p21, and 9 months (9M). At postnatal day 1, MFR pups weighed significantly less compared to control pups, but at p21 and 9M, they weighed significantly more. However, lung weight, expressed as a percentage of body weight between the two groups was not different at all time-points examined. The MFR group had significantly decreased alveolar number and significantly increased septal thickness at p1 and 9M, indicating significantly altered lung structure in the MFR offspring. Furthermore, although at p1, compared to the control group, lung lipid accumulation was significantly decreased in the MFR group, at 9M, it was significantly increased. There were significant temporal changes in the parathyroid hormone-related protein/peroxisome proliferator-activated receptor gamma signaling pathway and surfactant synthesis. We conclude that MFR alters fetal lung lipid differentiation programming and lung morphometry by affecting specific epithelial-mesenchymal signaling pathways, offering the possibility for specific interventions to overcome these effects.
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Affiliation(s)
- Ahmet Karadag
- Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute at Harbor-UCLA, David Geffen School of Medicine at UCLA, Torrance, California 90502, USA
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9
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Morrison JL, Orgeig S. Review: Antenatal Glucocorticoid Treatment of The Growth-restricted Fetus: Benefit or Cost? Reprod Sci 2009; 16:527-38. [DOI: 10.1177/1933719109332821] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Janna L. Morrison
- Sansom Institute, University of South Australia, Adelaide, South Australia, Australia, , Early Origins of Adult Health Research Group, University of South Australia, Adelaide, South Australia, Australia
| | - Sandra Orgeig
- Sansom Institute, University of South Australia, Adelaide, South Australia, Australia
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10
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Besnard V, Wert SE, Kaestner KH, Whitsett JA. Stage-specific regulation of respiratory epithelial cell differentiation by Foxa1. Am J Physiol Lung Cell Mol Physiol 2005; 289:L750-9. [PMID: 16214823 DOI: 10.1152/ajplung.00151.2005] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Foxa1 is a member of the winged helix family of transcription factors that is expressed in epithelial cells of the conducting airways and in alveolar type II cells of the lung. To determine the role of Foxa1 during lung morphogenesis, histology and gene expression were assessed in lungs from Foxa1-/- gene-targeted mice from embryonic day (E) 16.5 to postnatal day (PN) 13. Deletion of Foxa1 perturbed maturation of the respiratory epithelium at precise times during lung morphogenesis. While dilatation of peripheral lung saccules was delayed in Foxa1-/- mice at E16.5, sacculation was unperturbed later in development (E17.5-E18.5). At PN5, alveolarization was markedly delayed in Foxa1-/- mice; however, by PN13 lung histology was comparable to wild-type controls. Clara cell secretory protein (CCSP), prosurfactant protein (SP)-C, and SP-B protein content and immunostaining were decreased in Foxa1-/- mice between E16.5 and E18.5 but normalized after birth. Timing and sites of expression of thyroid transcription factor-1, Foxj1, and beta-tubulin were unaltered in lungs of Foxa1-/- mice. In vitro, Foxa1 regulated the activity of CCSP and SP-A, SP-B, SP-C, and SP-D promoters as assessed by luciferase reporter assays in HeLa, H441, and MLE15 cells. Although Foxa1 regulates respiratory epithelial differentiation and structural maturation of the lung at precise developmental periods, the delay in maturation is subsequently compensated at times to enable respiratory function and restore normal lung structure after birth.
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Affiliation(s)
- V Besnard
- Department of Pediatrics, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA
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11
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Dias CM, Pássaro CP, Cagido VR, Einicker-Lamas M, Lowe J, Negri EM, Capelozzi VL, Zin WA, Rocco PRM. Effects of undernutrition on respiratory mechanics and lung parenchyma remodeling. J Appl Physiol (1985) 2004; 97:1888-96. [PMID: 15194671 DOI: 10.1152/japplphysiol.00091.2004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Undernutrition thwarts lung structure and function, but there are disagreements about the behavior of lung mechanics in malnourished animals. To clarify this issue, lung and chest wall mechanical properties were subdivided into their resistive, elastic, and viscoelastic properties in nutritionally deprived (ND) rats and correlated with the data gathered from histology (light and electron microscopy and elastic fiber content), and bronchoalveolar lavage fluid analysis (lipid and protein content). Twenty-four Wistar rats were assigned into two groups. In the control (Ctrl) group the animals received food ad libitum. In the ND group, rats received one-third of their usual daily food consumption until they lost 40% of their initial body weight. Lung static elastance, viscoelastic and resistive pressures (normalized by functional residual capacity), and chest wall pressures were higher in the ND group than in the Ctrl group. The ND group exhibited patchy atelectasis, areas of emphysema, interstitial edema, and reduced elastic fiber content. The amount of lipid and protein in bronchoalveolar lavage fluid was significantly reduced in the ND group. Electron microscopy showed 1) type II pneumocytes with a reduction in lamellar body content, multilamellated structures, membrane vesicles, granular debris, and structurally aberrant mitochondria; and 2) diaphragm and intercostals with atrophy, disarrangement of the myofibrils, and deposition of collagen type I fibers. In conclusion, undernutrition led to lung and chest wall mechanical changes that were the result from a balance among the following modifications: 1) distorted structure of diaphragm and intercostals, 2) surfactant content reduction, and 3) decrease in elastic fiber content.
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Affiliation(s)
- Cristina Márcia Dias
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Centro de Ciências da Saúde, Ilha do Fundão, 21949-900 Rio de Janeiro, Brazil
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12
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Chen CM, Wang LF, Su B. Effects of maternal undernutrition during late gestation on the lung surfactant system and morphometry in rats. Pediatr Res 2004; 56:329-35. [PMID: 15201404 DOI: 10.1203/01.pdr.0000134254.83113.8e] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intrauterine growth restriction (IUGR) is associated with reduced lung function during infancy and throughout adulthood. We investigated the effects of maternal undernutrition (50% rations of the control food intake) during the last week of gestation on the pulmonary surfactant system and lung morphometry in postnatal rats. IUGR rats exhibited a significantly lower body weight, lower lung weight, lower lung/body weight ratio, lower lung volume, and lower lung volume/body weight ratio on some postnatal days. IUGR rats had a significantly lower lung saturated phosphatidylcholine and lower plasma corticosterone levels on postnatal d 1 only, and values were comparable between control and IUGR rats in the ensuing weeks. Lung surfactant protein (SP)-A, SP-B, SP-C, and SP-D mRNA expressions were similar between control and IUGR rats. Volume fractions of the alveolar airspace were significantly lower in IUGR rats on postnatal d 7, 14, and 42. Alveolar surface areas were significantly lower in IUGR rats during the study period. The alveolar surface area/body weight ratio reached a peak on postnatal d 7, and values were significantly lower in IUGR rats on postnatal d 1, 14, 28, and 42. We conclude that maternal undernutrition during late gestation decreases lung surfactant lipid levels in the immediate postnatal period and alters the development of lung structure during the postnatal period. Alteration of lung surfactant and structure may be important in the pathogenesis of impaired pulmonary function in IUGR infants and children.
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Affiliation(s)
- Chung-Ming Chen
- Department of Pediatrics, Taipei Medical University Hospital, Taipei 110, Taiwan.
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Lucas JS, Inskip HM, Godfrey KM, Foreman CT, Warner JO, Gregson RK, Clough JB. Small size at birth and greater postnatal weight gain: relationships to diminished infant lung function. Am J Respir Crit Care Med 2004; 170:534-40. [PMID: 15172897 DOI: 10.1164/rccm.200311-1583oc] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Recent evidence suggests that impaired lung development is linked with diminished lung function and an increased risk of chronic obstructive airway disease in adulthood. To examine environmental influences on early lung development, we measured lung function in 131 normal-term infants aged 5-14 weeks. Adjusting for age at measurement, FEV at 0.4 seconds fell by 4.4% for each standard deviation decrease in birth weight (p = 0.047); when adjusted for FVC, FEV at 0.4 seconds was not related to birth weight but fell by 3.2% per standard deviation increase in infant weight gain (p = 0.001). Age- and sex-adjusted total respiratory system compliance fell by 7.0% per standard deviation decrease in birth weight (p < 0.001) but was not related to infant weight gain. In univariate analyses, age-adjusted forced expiratory flow at functional residual capacity was not related to birth weight, but decreased by 11.0% per standard deviation increase in infant weight gain (p = 0.007). The respiratory rate rose by 5.1% per standard deviation increase in infant weight gain (p = 0.001). Lung function measurements were not related to infant feeding. The observations suggest that lower rates of fetal growth and higher rates of early infancy weight gain are associated with impaired lung development.
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Affiliation(s)
- Jane S Lucas
- B.M., MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD, UK
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14
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Mallampalli RK, Ryan AJ, Carroll JL, Osborne TF, Thomas CP. Lipid deprivation increases surfactant phosphatidylcholine synthesis via a sterol-sensitive regulatory element within the CTP:phosphocholine cytidylyltransferase promoter. Biochem J 2002; 362:81-8. [PMID: 11829742 PMCID: PMC1222362 DOI: 10.1042/0264-6021:3620081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lipid-deprived mice increase alveolar surfactant disaturated phosphatidylcholine (DSPtdCho) synthesis compared with mice fed a standard diet by increasing expression of CTP:phosphocholine cytidylyltransferase (CCT), the rate-limiting enzyme for DSPtdCho synthesis. We previously observed that lipid deprivation increases mRNA synthesis for CCT [Ryan, McCoy, Mathur, Field and Mallampalli (2000) J. Lipid Res. 41, 1268-1277]. To evaluate regulatory mechanisms for this gene, we cloned the proximal approximately 1900 bp of the 5' flanking sequence of the murine CCT gene, coupled this to a luciferase reporter, and examined transcriptional regulation in a murine alveolar epithelial type II cell line (MLE-12). The core promoter was localized to a region between -169 and +71 bp, which exhibited strong basal activity comparable with the simian virus 40 promoter. The full-length construct, from -1867 to +71, was induced 2-3-fold when cells were cultured in lipoprotein-deficient serum (LPDS), similar to the level of induction of the endogenous CCT gene. By deletional analysis the sterol regulatory element (SRE) was localized within a 240 bp region. LPDS activation of the CCT promoter was abolished by mutation of this SRE, and gel mobility-shift assays demonstrated specific binding of recombinant SRE-binding protein to this element within the CCT promoter. These observations indicate that sterol-regulated expression of CCT is mediated by an SRE within its 5' flanking region.
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15
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Johnston SD, Daniels CB. Development of the pulmonary surfactant system in non-mammalian amniotes. Comp Biochem Physiol A Mol Integr Physiol 2001; 129:49-63. [PMID: 11369533 DOI: 10.1016/s1095-6433(01)00305-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Pulmonary surfactant (PS) is a complex mixture of phospholipids, neutral lipids and proteins that lines the inner surface of the lung. Here, it modulates surface tension thereby increasing lung compliance and preventing the transudation of fluid. In mammals, the PS system develops towards the end of gestation, characterized by an increase in the saturation of phospholipids in lung washings and the appearance of surfactant proteins in amniotic fluid. Birth, the transition from in utero to the external environment, is a rapid process. At this time, the PS system is important in opening and clearing the lung of fluid in order to initiate pulmonary ventilation. In oviparous vertebrates, escape from an egg can be a long and exhausting process. The young commence pulmonary ventilation and hatching by 'pipping' through the eggshell, where they remain for some time, presumably clearing their lungs. This paper relates changes in the development of the pulmonary surfactant system within the non-mammalian amniotes in response to birth strategy, lung morphology and phylogeny in order to determine the conservatism of this developmental process. Total phospholipid (PL), disaturated phospholipid (DSP) and cholesterol (Chol) were quantified from lung washings of embryonic and hatchling chickens, bearded dragons (oviparous), sleepy lizards (viviparous), snapping turtles and green sea turtles throughout the final stages of incubation and gestation. In all cases, the pattern of development of the pulmonary surfactant lipids was consistent with that of mammals. PL and DSP increased throughout the latter stages of development and Chol was differentially regulated from the PLs. Maximal secretion of both PL and DSP occurred at 'pipping' in oviparous reptiles, coincident with the onset of airbreathing. Similarly, the amount of DSP relative to total PL was maximal immediately after the initiation of airbreathing in chickens. The relative timing of the appearance of the lipids differed between groups. In the oviparous lizard, surfactant lipids were released over a relatively shorter time than that of the sleepy lizard, turtles, birds and mammals. Thus, despite temporal differences and vastly different lung morphologies, birth strategies and phylogenies, the overall development and maturation of the PS system is highly conserved amongst the amniotes.
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Affiliation(s)
- S D Johnston
- Department of Physiology, University of Adelaide, SA 5005, Adelaide, Australia
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16
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Harding R, Cock ML, Louey S, Joyce BJ, Davey MG, Albuquerque CA, Hooper SB, Maritz GS. The compromised intra-uterine environment: implications for future lung health. Clin Exp Pharmacol Physiol 2000; 27:965-74. [PMID: 11117232 DOI: 10.1046/j.1440-1681.2000.03379.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
1. Epidemiological studies of infants, children and adults indicate that prenatal compromises that restrict fetal growth and cause low birthweight increase the risk of respiratory deficiencies after birth. 2. It is apparent that the lung has a limited ability to recover from early developmental compromises and that altered development can permanently impair lung architecture. 3. Lung development in utero can be adversely affected by factors associated with fetal growth restriction, namely fetal hypoxaemia, reduced substrate supply and hypercortisolaemia. 4. We have conducted a series of studies of respiratory development in chronically catheterized ovine fetuses and postnatal lambs in which growth restriction was induced during late gestation by embolizing the umbilico-placental vascular bed, a technique that replicates key aspects of human placental insufficiency. 5. During late gestation, restricting the growth of the ovine fetus did not alter lung weight or lung liquid secretion or volume when each factor was related to bodyweight, but it did lead to increased lung DNA concentrations and an increased thickness of the air-blood barrier. Expression of pulmonary surfactant proteins A, B and C were not altered and, hence, it was unlikely that surfactant protein synthesis had been impaired by growth restriction. 6. When growth restriction continued to term, lambs were born with a low birthweight and remained small compared with controls for 8 weeks after birth. Low-birthweight lambs were mildy hypoxaemic and compliances of their lungs and chest wall were, respectively, decreased and increased relative to controls. Pulmonary surfactant proteins A, B and C were not deficient, indicating that decreased lung compliance most likely had a structural basis.
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Affiliation(s)
- R Harding
- Department of Physiology, Monash University, Clayton, Victoria, Australia.
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Harding R, Tester ML, Moss TJ, Davey MG, Louey S, Joyce B, Hooper SB, Maritz G. Effects of intra-uterine growth restriction on the control of breathing and lung development after birth. Clin Exp Pharmacol Physiol 2000; 27:114-9. [PMID: 10696539 DOI: 10.1046/j.1440-1681.2000.03191.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
1. Low birthweight is now recognized as an important risk factor for early postnatal respiratory illness and it is becoming evident that low birthweight can increase the risk for airway dysfunction in children and adults. Our studies have been aimed at determining how low birthweight, resulting from intra-uterine growth restriction (IUGR), affects the control of breathing and the structural and functional development of the lung. 2. We have measured ventilatory responsiveness to progressive hypoxia and progressive hypercapnia during the first weeks after birth in postnatal lambs in which IUGR was induced by chronic placental insufficiency. It was found that the postnatal increase in ventilatory sensitivity to hypoxia observed in control lambs was diminished in low birthweight lambs; in contrast, the sensitivity to hypercapnia was not affected. In other studies, we found that IUGR caused by maternal anaemia led to elevated CO2 levels during sleep and wakefulness. 3. Our findings suggest that the prenatal development of the brain-stem or respiratory chemoreceptors may be affected by intra-uterine factors associated with IUGR, such as foetal hypoxaemia or hypoglycaemia. It is also possible that the structure of respiratory muscles and, hence, their ability to maintain a high level of ventilation may be affected by IUGR. 4. Recently, we studied the influence of IUGR on foetal lung development, in particular its effects on foetal lung liquid, a major determinant of lung growth, as well as alveolar structure and pulmonary surfactant. Lung liquid secretion and volume, in relation to bodyweight, were unaffected; however, there was evidence of structural and functional immaturity in the lungs. In foetuses exposed to IUGR, the air-blood barrier was thicker and, after birth, the diffusing capacity of the lungs for carbon monoxide was lower. In contrast, surfactant protein gene expression was enhanced, particularly in foetuses with high levels of circulating cortisol. 5. Further studies are needed to characterize the effects of specific types of prenatal compromise on postnatal control of ventilation and lung function, to determine mechanisms underlying these effects and to determine the capacity for postnatal recovery.
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Affiliation(s)
- R Harding
- Department of Physiology, Monash University, Melbourne, Victoria, Australia.
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Abstract
Hyperglycemia has been implicated as a cause of delayed fetal lung maturation in the diabetic pregnancy. It has been previously demonstrated that high glucose levels inhibit biochemical and morphological maturation of fetal rat lung in vitro. To explore whether there is a critical period for maximal effects of high glucose, fetal rat lung explants from day 18-22 (term) were examined after culture for 44 h in media containing 10 or 100 mM glucose. Rate of choline incorporation into PC and DSPC was significantly decreased in explants derived from day 20-22 fetuses after culture with high glucose. Paradoxically, in explants derived from day 18-19 fetuses choline incorporation rate was increased. Significant decreases in total PC and DSPC were seen in the high glucose group on days 20-21; however, earlier in gestation no differences in PC and DSPC were noted, despite the higher rate of choline incorporation into PC and DSPC, suggesting an increased turnover rate. High glucose levels also resulted in significantly decreased incorporation of labeled glycerol and palmitate into PC. Morphologic analysis of right upper lobe explants revealed significant decreases in the number of type II pneumocytes and lamellar bodies per alveolar lining cell in high glucose treated explants derived from days 19-20, but not before or after that time in gestation. Prior to day 20 there were few luminal lamellar bodies in potential airspaces. By day 20, the high glucose group had significantly fewer luminal lamellar bodies, although by day 21 the difference was no longer significant. These results suggest that high glucose may have a greater inhibitory effect late in gestation and that there may be critical periods in lung development when differences in substrate availability and utilization have differing effects.
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Affiliation(s)
- I H Gewolb
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore 21201, USA
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