Document Detail


Ibuprofen-induced patent ductus arteriosus closure: physiologic, histologic, and biochemical effects on the premature lung.
MedLine Citation:
PMID:  18450898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The goal was to study the pulmonary, biochemical, and morphologic effects of a persistent patent ductus arteriosus in a preterm baboon model of bronchopulmonary dysplasia. METHODS: Preterm baboons (treated prenatally with glucocorticoids) were delivered at 125 days of gestation (term: 185 days), given surfactant, and ventilated for 14 days. Twenty-four hours after birth, newborns were randomly assigned to receive either ibuprofen (to close the patent ductus arteriosus; n = 8) or no drug (control; n = 13). RESULTS: After treatment was started, the ibuprofen group had significantly lower pulmonary/systemic flow ratio, higher systemic blood pressure, and lower left ventricular end diastolic diameter, compared with the control group. There were no differences in cardiac performance indices between the groups. Ventilation index and dynamic compliance were significantly improved with ibuprofen. The improved pulmonary mechanics in ibuprofen-treated newborns were not attributable to changes in levels of surfactant protein B, C, or D, saturated phosphatidylcholine, or surfactant inhibitory proteins. There were no differences in tracheal concentrations of cytokines commonly associated with the development of bronchopulmonary dysplasia. The groups had similar messenger RNA expression of genes that regulate inflammation and remodeling in the lung. Lungs from ibuprofen-treated newborns were significantly drier (lower wet/dry ratio) and expressed 2.5 times more epithelial sodium channel protein than did control lungs. By 14 days after delivery, control newborns had morphologic features of arrested alveolar development (decreased alveolar surface area and complexity), compared with age-matched fetuses. In contrast, there was no evidence of alveolar arrest in the ibuprofen-treated newborns. CONCLUSIONS: Ibuprofen-induced patent ductus arteriosus closure improved pulmonary mechanics, decreased total lung water, increased epithelial sodium channel expression, and decreased the detrimental effects of preterm birth on alveolarization.
Authors:
Donald McCurnin; Steven Seidner; Ling-Yi Chang; Nahid Waleh; Machiko Ikegami; Jean Petershack; Brad Yoder; Luis Giavedoni; Kurt H Albertine; Mar Janna Dahl; Zheng-ming Wang; Ronald I Clyman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  121     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-02     Completed Date:  2008-06-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  945-56     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Bronchoalveolar Lavage Fluid / chemistry
Ductus Arteriosus, Patent / drug therapy*,  metabolism,  physiopathology
Epithelial Sodium Channel / metabolism
Extravascular Lung Water / metabolism
Female
Fetal Organ Maturity / drug effects
Hemodynamics
Ibuprofen / therapeutic use*
Inflammation Mediators / metabolism
Lung / anatomy & histology,  drug effects*,  embryology,  physiology
Male
Papio papio
Phosphatidylcholines / metabolism
Pulmonary Surfactant-Associated Proteins / metabolism
Respiration
Grant Support
ID/Acronym/Agency:
HL46691/HL/NHLBI NIH HHS; HL52636/HL/NHLBI NIH HHS; HL56061/HL/NHLBI NIH HHS; HL56401/HL/NHLBI NIH HHS; HL62875/HL/NHLBI NIH HHS; HL63329/HL/NHLBI NIH HHS; HL63397/HL/NHLBI NIH HHS; HL63399/HL/NHLBI NIH HHS; P51RR13986/RR/NCRR NIH HHS; R24 RR023345/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Epithelial Sodium Channel; 0/Inflammation Mediators; 0/Phosphatidylcholines; 0/Pulmonary Surfactant-Associated Proteins; 15687-27-1/Ibuprofen

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