Lung growth factors in the amniotic fluid of normal pregnancies and with congenital diaphragmatic hernia
Lung growth factors in the amniotic fluid of normal pregnancies and with congenital diaphragmatic hernia
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DOI：
10.3109/14767058.2015.1076387
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发表时间：
2016-01-01
影响因子：
1.8
通讯作者：
Pederiva, Federica
中科院分区：
文献类型：
--
作者：
Candilera, Vanessa;Bouche, Carlo;Pederiva, Federica
目的：肺发育不良继发呼吸衰竭是先天性横隔疝(CDH)的主要死亡原因。肺生长受生长因子(GFS)的调节，其失衡在病理条件下被报道。我们测定了CDH患者羊水中调节肺部发育的GFS水平，并与正常妊娠进行了比较。方法：收集4例CDH患者和12例正常妊娠患者羊水，分别于羊膜穿刺术和分娩时采集。分离和定量GFS。对3例CDH死亡新生儿的尸检肺组织中GFS进行检测。结果：CDH组羊水中GFS表达较正常组明显降低。羊膜腔穿刺术中成纤维细胞生长因子10(FGF10)、成纤维细胞生长因子7(FGF7)、血管内皮生长因子和转化生长因子-β(TGF-β)降低，而血小板衍生生长因子(PDGF)升高。当FGF10和PDGF在分娩时趋于正常时，表皮生长因子增加，而转化生长因子β仍降低。CDH死亡儿的双肺GFS表达相似。结论：通过检测胎儿和CDH死亡儿的羊水中GFS表达水平，可以发现胎儿和CDH胎儿肺中GFS表达的异常。进一步的研究将有助于将GFS的产前表达与出生后CDH的临床结局联系起来。
Aim: Respiratory failure secondary to pulmonary hypoplasia is the main cause of death in congenital diaphragmatic hernia (CDH). Lung growth is regulated by growth factors (GFs), whose imbalances are reported in pathological conditions. We measured amniotic fluid levels of GFs, regulating lung development, in pregnancies with CDH and compared them with normal gestations.Methods: Amniotic fluid was collected at amniocentesis and delivery from 4 women carrying fetuses with CDH and 12 with normal pregnancy. GFs were isolated and quantified. Same GFs were measured in lung biopsies collected during autopsy of three newborns dead of CDH.Results: Impairment expression of lung GFs in the amniotic fluid of CDH pregnancies in comparison with normal was found. Fibroblast growth factor 10 (FGF10), fibroblast growth factor 7, vascular endothelial growth factor and transforming growth factor beta (TGF beta) were decreased at amniocentesis, while platelet-derived growth factor (PDGF) increased. While FGF10 and PDGF tended to normalize at delivery, epidermal growth factor increased and TGF beta was still decreased. Same GFs were similarly expressed in both lungs of babies dead of CDH.Conclusion: Anomalies in lung GFs expression of embryos and fetuses with CDH can be detected by measuring their levels in the amniotic fluid during pregnancy. Further investigation would help to correlate prenatal expression of GFs and clinical outcome of babies with CDH after birth.