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[Case of poorly differentiated cancer of the lung developing in a tuberculous cavern].
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Effects of maternal dexamethasone therapy on fetal lung development in the rhesus monkey.
A large body of evidence demonstrates that antenatal glucocorticoids can accelerate fetal lung maturation. The purpose of this study was to delineate the optimal dose of dexamethasone and to determine whether a single- or multiple-injection regimen of the same total dexamethasone dosage was more effective in accelerating pulmonary development. Pregnant rhesus monkeys were injected with varying doses of dexamethasone or vehicle as either a single-bolus injection or as four separate injections, each spaced 12 hours apart. All maternal treatments were begun exactly 72 hours prior to delivery, and all fetuses were delivered by cesarean section at 135 +/- 1 days gestation. When a single injection of dexamethasone was used, fetal liver weight increased in a dose-related fashion. Fetal and maternal cortisol and fetal blood glucose concentrations were also influenced by increasing dexamethasone dosages. Fetal pulmonary phospholipids, however, were unchanged at all steroid doses examined. Multiple injections of dexamethasone generally produced more pronounced effects, even though the total dexamethasone dose remained the same. Thus, liver weight and fetal and maternal cortisol, glucose, and insulin levels were significantly influenced by the multiple administration of dexamethasone. In addition, total lung phosphatidylcholine, surfactant phosphatidylcholine, the surfactant-phosphatidylcholine-to-total-phosphatidylcholine ratio, and the surfactant-disaturated-phosphatidylcholine-to-total-lung-disaturated- phosphatidylcholine ratio were elevated after the multiple-injection regimen. A total dose of 0.5 mg dexamethasone/kg maternal body weight given in four separate injections appeared to produce the most beneficial results. These data suggest that low-dose, antenatal glucocorticoid treatment can effectively accelerate the biochemical maturation of the fetal lung.
Clearance of refractory ceramic fibers (RCF) from the rat lung: development of a model.
Chronic exposure and postexposure experiments have been recently performed in rats to evaluate the biological responses of inhaled refractory ceramic fibers (RCF) at different concentration levels. The lung burden data in the accessory lobe of the rat lung were collected during and after different exposure and postexposure periods. The size distribution of retained fibers in the lung at different time points was also measured. We used these data to develop a mathematical model of fiber clearance from the rat lung. It was found that the clearance rate did not depend significantly upon fiber size but there was a clear dependence on lung burden. As lung burden increased, the clearance rate was found to decrease. An empirical equation was derived for the clearance rate as a function of lung burden. At low burdens, rats had a retention half-time of about 126 days for RCF compared to a typical half-time of about 60 days for insoluble nonfibrous particles.
The biochemistry of fetal lung development.
Surfactant therapy for RDS is likely to become widespread in the near future. Animal data indicate that this will not preclude a role for hormonal acceleration of lung maturation. In studies with prematurely delivered and ventilated fetal rabbits, Fiascone et al. have shown that the administration of betamethasone antenatally improves lung compliance, as does intratracheal administration of excess amounts of adult rabbit natural surfactant. If the two therapies are combined, however, an additive effect is observed. This suggests that some of the effects of glucocorticoids on lung compliance are not related to surfactant. Prior glucocorticoid therapy may provide a benefit that differs from that of surfactant therapy because steroids mature the lungs anatomically and enhance nonsurfactant-related tissue compliance. It is also possible that surfactant therapy itself may be more effective in the presence of larger and increased numbers of alveoli. It thus seems likely that in the future both hormonal enhancement of lung maturation and surfactant therapy may be used in combination to further reduce the morbidity and mortality from RDS.
Immunolocalization of transforming growth factor-alpha, epidermal growth factor (EGF), and EGF-receptor in normal and injured developing human lung.
The family of growth factors that includes epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) are thought to play a role in the regulation of fetal lung development and epithelial repair after injury. To further elucidate the potential role of these growth factors and their receptor in normal human lung development and in response to injury, their distribution was determined by immunohistochemistry in normal fetal lung, as well as both normal and injured postnatal human lung. We studied 14 specimens of human lung tissue: from three fetuses, four normal infants, two preterm infants with hyaline membrane disease, and five infants with late bronchopulmonary dysplasia (BPD). EGF, TGF-alpha, and EGF receptor (EGF-R) colocalized in airway epithelium in normal fetal and in postnatal human lung. They were also colocalized in scattered alveolar epithelial cells in postnatal lung. Large numbers of alveolar macrophages immunostained for EGF, TGF-alpha, and EGF-R in lungs with late stages of BPD. The colocalization of these growth factors suggests parallel expression of EGF family members. Moreover, the colocalization of these growth factors with their receptor in developing lung suggests that they may act through an autocrine mechanism. The prominent expression of these growth factors in alveolar macrophages in BPD suggests they may be involved with the pathogenesis of this disease.
In vivo localization of the insulin-like growth factors I and II (IGF I and IGF II) gene expression during human lung development.
The insulin-like growth factors I and II (IGF I and IGF II) are synthesized in many organs during human development and are involved in the growth and differentiation of tissues. Correlations between lung growth and maturation and the local production of IGFs have been poorly explored in humans. Using in situ hybridization we localized the synthesis of IGFs in the human fetal respiratory tract over an extended period of the gestation and we demonstrated time dependent changes. IGF mRNAs were expressed throughout gestation with a clear predominance of IGF II and a decreasing expression of both IGFs after the 20th week of gestation. They were mainly detected in the mesodermal-derived components of the respiratory tract, especially in the undifferentiated mesenchyme of the lung buds up to 20 weeks of gestation. At this time the local production of collagen and the proliferation of adjacent epithelial cells were predominant features. Later, mesenchymal hybridization decreased. Weak epithelial hybridization was observed during the first stages of growth and progressively decreased when the epithelium underwent maturation: early in the trachea, later in the distal lung buds. A consistent expression of IGF II, but not IGF I, in the endothelium, throughout gestation, was also observed. The IGFs may act on the near epithelial cell proliferation in both autocrine and paracrine ways. They may also stimulate the maturation of the connective tissue. This endogenous production of growth factors may play a role in the somatic growth during prenatal life.
Postnatal lung development and its impairment by glucocorticoids.
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The new BPD: an arrest of lung development.
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[Blast injuries of the lung: development, prognosis and possible therapy].
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Fetal lung development in pregnancies of diabetic women assessed by quantitative ultrasonic tissue characterization.
OBJECTIVES: This study was performed to compare quantitative ultrasonic tissue characterization of the fetal lung at different gestational ages in uncontrolled diabetic patients with that in normal uncomplicated pregnancies. METHODS: A total of 44 women at 24-37 weeks' gestation with the diagnosis of diabetes in pregnancy were enrolled. Data were compared to those of the control group, which consisted of 140 women with uncomplicated pregnancies of the same gestational age. Longitudinal and transverse sections of the fetal thorax and upper abdomen were examined. A region of interest of constant size was defined and the tissue-specific gray scale was determined by using interactive software. RESULTS: Compared with normal pregnancies, fetal lungs of diabetic pregnancies have a higher echogenicity between 28 and 37 weeks of gestation. The lung mean gray values (MGV) only differed significantly between 30 and 31 weeks of gestation in the group with diabetes (P = 0.033) compared to the control group. The MGV of the liver in diabetic and normal pregnancies is similar during pregnancy, significant differences being found only at 30-31 weeks of gestation (P = 0.038). The lung-to-liver ratio in the control group showed a significant increase from 24 to 31 weeks and a slight non-significant decrease after 31 weeks. The ratio in the group with diabetes increased slightly up to week 33 and decreased slightly afterwards. CONCLUSION: Fetal lung MGV in uncontrolled diabetic pregnancies compared to that in uncomplicated pregnancies differs significantly only between 30 and 31 weeks of gestation.
Monoclonal antibody identification of a type II alveolar epithelial cell antigen and expression of the antigen during lung development.
A monoclonal antibody identifying an antigen expressed by rat type II alveolar epithelial cells, but not by type I epithelial cells or other mature lung cells, was produced by immunization of mice with cells of the rat L2 cell line. The antigen recognized by the antibody was present on the microvillous luminal surface of type II epithelial cells. In adult rat lung, only type II epithelial cells bound the antibody. During fetal development the antigen was expressed by cuboidal epithelial cells lining the respiratory ducts of the first divisions of the tracheal bud, but not by epithelial cells lining the esophagus or trachea. The antigen continued to be expressed by cuboidal epithelial cells lining the larger respiratory ducts until approximately 19 days gestational age. Thereafter, expression was increasingly limited to selected single cells or clusters of two to four cuboidal cells in the smallest ducts. By the 21st postnatal day, the antigen was expressed only by type II alveolar epithelial cells. Type II alveolar epithelial cells isolated from adult lung and the L2 cell line in culture expressed the antigen on the cell surface. A protein of approximately 146,000 Mr was isolated by immunoadsorption of the antigen from non-ionic detergent extracts of type II cells and L2 cells. Preliminary studies of the binding of the antibody to other rat tissues indicate that the antibody binds to renal proximal tubular epithelial cells of the kidney and the luminal surface of the small bowel epithelial cells.
Molecular cloning and characterization of a novel gene upregulated early during postnatal rat lung development.
Alveoli form, in part, by subdivision (septation) of saccules constituting the gas exchange region of the immature lung. Rat lungs septate from postnatal day 4 through 14 but alveoli in male rats continue to form, by other means, until about age 44 days. In rats, we sought to identify genes involved in septation. Using differential display reverse transcription polymerase chain reaction, we cloned a cDNA, rA5D3, that had 1270 bp with an open reading frame encoding a putative polypeptide of 165 amino acids containing potential leucine zipper motifs and phosphorylation sites. Database searches indicated rA5D3 was a novel gene. rA5D3 RNA relative concentration increased 1.7-fold between postnatal days 4 and 8, decreased 4-fold between days 8 and 14, declined significantly thereafter but was still detected post alveolus formation. If the expression of rA5D3 protein resembles its RNA, its peak (postnatal day 8) is well after the onset of septation, suggesting a role other than the initiation of septation.
Lung development and repair: contribution of the ciliated lineage.
The identity of the endogenous epithelial cells in the adult lung that are responsible for normal turnover and repair after injury is still controversial. In part, this is due to a paucity of highly specific genetic lineage tools to follow efficiently the fate of the major epithelial cell populations: the basal, secretory, ciliated, neuroendocrine, and alveolar cells. As part of a program to address this problem we have used a 1-kb FOXJ1 promoter to drive CreER in the ciliated cells of the embryonic and adult lung. Analysis of FOXJ1-GFP transgenic lungs shows that labeled cells appear in a proximal-distal pattern during embryogenesis and that the promoter drives expression in all ciliated cells. Using FOXJ1CreER adult mice, we have followed the fate of ciliated cells after epithelial injury by naphthalene or sulfur dioxide. From quantitative analysis and confocal microscopy we conclude that ciliated cells transiently change their morphology in response to lung injury but do not proliferate or transdifferentiate as part of the repair process.
The effect of prolonged oligohydramnios on fetal lung development, maturation and ventilatory patterns in the newborn guinea pig.
We drained the amniotic fluid surrounding guinea pig fetuses between days 45 and 65 of gestation (term is 67 days). The fetuses were delivered by Cesarean section and the impact of prolonged oligohydramnios on lung growth, maturation and postnatal ventilatory pattern was measured. Untouched littermate fetuses served as controls. Neither fetal body, liver nor brain weights were significantly affected by the experimental situation. When expressed in percent of control values, lung weight (63%), lung/body weight ratio (70%), lung volume (67%), total lung DNA content (63%) and lung DNA per gram of fetal weight (71%) were all significantly less following amniotic fluid drainage, confirming the diagnosis of lung hypoplasia. Disaturated phosphatidylcholine content per gram of lung tissue and total lung glycogen content were not affected by the procedure, indicating that the maturity of the hypoplastic lungs was not delayed. When measured 4 to 6 hours after birth, tidal volume was significantly less (62%) and respiratory frequency was significantly more (137%); however, minute ventilation per unit of body weight was not significantly changed. This animal model of sublethal lung hypoplasia could become useful to study the potential for, and the kinetics of, postnatal catch-up lung growth about which little is known.
Regulation of transferrin gene expression during lung development and injury.
Transferrin (TF), the major iron-transporting protein in vertebrates, is mainly synthesized in the liver. Although its source in lung is unknown, TF is a major inhibitor for lipid peroxidation and microbial propagation in lung fluid, and iron-free TF has been shown in rabbits to decrease the severity of respiratory failure and to improve surfactant activity. This study shows that TF is produced and secreted by the lung. In baboons and humans. TF gene expression displays distinct temporal patterns in different lung cells as revealed by in situ hybridization. Although expression of TF mRNA in submucosal glands remains active during development and throughout adulthood, its level in airway epithelial increases with advancing gestational age, reaches its peak before birth, declines 6-12 mo after birth, and diminishes in the older adult. In premature baboons maintained on ventilatory support, expression of TF mRNA is suppressed in both airway epithelium and glands. TF production by airway epithelia before birth most likely prevents oxidative damage in the newborn period, and its loss during injury may allow further lung damage.
[Effects of U74389G on pulmonary macrophage influx and lung development in 95% O2 exposed newborn rats].
OBJECTIVE: Oxygen toxicity is believed to play a critical role in the pathogenesis of bronchopulmonary dysplasia (BPD). U74389G, a potent 21-aminosteroid antioxidant, was applied to the 95% O(2) induced acute lung injury in newborn rat model. The present study aimed to investigate the mechanism of hyperoxic lung injury and the interaction of possible mediators, and to explore the effect of antioxidant intervention. METHODS: Newborn Sprague-Dawley rats were randomly divided into four groups: air-exposed control, air-exposed treated with U74389G, hyperoxia-exposed control, hyperoxia-exposed treated with U74389G. Hydroxyl radical formation (2,3-DHBA and 2,5-DHBA) was assessed by an aromatic hydroxylation assay using GC/MS with salicylate as the probe. The 8-isoprostane, a specific marker for in vivo lipid peroxidation, was quantitated by enzyme immunoassay. Pulmonary macrophage influx and nitrotyrosine formation were measured by means of immunohistochemistry. (3)H-TdR (autoradiography) incorporation was assessed as an index of active lung cell growth. RESULTS: Exposure to 95% O(2) for 7 days induced significant lung injury and mortality. The contents of hydroxyl radical in the hyperoxia-exposed lungs were dramatically increased [(2,3-DHBA 49.2 +/- 3.5 pmol/mg), (2,5-DHBA 55.8 +/- 2.3 pmol/mg), P < 0.05) and were decreased by treatment with U74389G [(2,3-DHBA 37.9 +/- 2.4 pmol/mg), (2,5-DHBA 31.3 +/- 1.9 pmol/mg), P < 0.05). The level of 8-isoprostane in the lungs of 95% O(2)-exposed newborn rats was significantly raised (546.6 +/- 32.2 pg/mg, P < 0.05) and lowered down by U74389G (358.5 +/- 24.1 pg/mg, P < 0.05). This phenomenon was also observed in the air-exposed animals. Remarkable pulmonary macrophage infiltration was evident in hyperoxia-exposed newborn rats and was attenuated by U74389G treatment. Nitrotyrosine distributed in the lung parenchyma and epithelial cells of large airway of hyperoxia-exposed newborn rats. The extent of protein nitration was reduced by U74389G, but the oxygen induced morphological change was not significantly improved by U74389G treatment. Exposure to 95% O(2) induced lung growth arrest as shown by (3)H-TdR incorporation. U74389G partially preserved active lung cell growth in hyperoxia-exposed rats, but showed an inhibitory effect on normal lung cell growth. CONCLUSION: Through scavenging hydroxyl radical and lipid peroxides, U74389G could block pulmonary macrophage influx and partly avert alveolar development arrest in hyperoxia-exposed newborn rats. Antioxidant intervention holds promising in hyperoxic lung injury though cautions should be taken as possible interference on normal cell development.
Pulmonary hypoplasia and congenital diaphragmatic hernia: advances in the pathogenetics and regulation of lung development.
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