Document Detail


Surfactant levels after reversible tracheal occlusion and prenatal steroids in experimental diaphragmatic hernia.
MedLine Citation:
PMID:  11150450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: In normal lungs, fetal tracheal occlusion (TO) induces lung growth but decreases the number of type II cells; this is remedied if TO is released (TR) before delivery. In the current study, the effects of TO with or without TR on pulmonary structure and surfactant were assessed in the ovine model in which lung hypoplasia was induced by creation of a diaphragmatic hernia (CDH). METHODS: A left-sided CDH was created in fetal lambs at 80 days gestation; TO was done at 108 days; and TR at 129 days. All ewes were given 1 dose of glucocorticoids at 135 days. At 136 days, the fetus was delivered. Lung weight to body weight ratio, mean terminal bronchiole density, type II cell density, bronchoalveolar lavage fluid (BAL) phosphatidylcholine (PC), BAL surfactant protein A (SP-A) and B (SP-B), and lung tissue SP-A and SP-B were assessed in CDH, CDH with TO, CDH with TO and TR, and controls. RESULTS: CDH lungs were hypoplastic and structurally immature, but had increased type II cell density. TO with or without TR caused lung growth with normalization of lung parenchymal architecture and type II cell density. Although the BAL SP-A and BAL SP-B were similar in all 4 groups, the BAL PC was low in CDH with or without TO or TR. Also, lung tissue SP-B levels were low in CDH with or without TO or TR. However, lung tissue SP-A levels were normal in CDH, but low in CDH with TO with or without TR. CONCLUSIONS: Despite the finding that lung morphology was improved in CDH with TO with or without TR animals, surfactant content and composition remained abnormal. Although surfactant secreted early by the fetus into alveolar spaces contained normal levels of BAL SP-A and BAL SP-B, the low levels of BAL PC and low lung tissue stores of SP-B indicate that these experimental lambs may experience respiratory insufficiency soon after birth. This implies that prophylactic surfactant at birth might be beneficial for CDH.
Authors:
I Bratu; H Flageole; J M Laberge; F Possmayer; R Harbottle; S Kay; S Khalife; B Piedboeuf
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  36     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-03-06     Completed Date:  2001-05-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  122-7     Citation Subset:  IM    
Affiliation:
Division of Pediatric Surgery of The Montreal Children's Hospital and the Division of Obstetrics of The Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Betamethasone / pharmacology*
Enzyme-Linked Immunosorbent Assay
Female
Glucocorticoids / pharmacology*
Hernia, Diaphragmatic / congenital,  physiopathology*
Lung / cytology,  embryology*,  metabolism*
Membrane Proteins / metabolism
Microscopy, Electron
Phosphatidylcholines / metabolism
Pregnancy
Pulmonary Surfactants / metabolism*
Sheep
Trachea / surgery*
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Membrane Proteins; 0/Phosphatidylcholines; 0/Pulmonary Surfactants; 378-44-9/Betamethasone

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