Antenatal glucocorticoid corrects pulmonary immaturity in experimentally induced congenital diaphragmatic hernia in rats.
Congenital diaphragmatic hernia, a highly lethal condition, displays at term the pulmonary biochemical and morphologic immaturity characteristic of premature delivery. We hypothesized that antenatal glucocorticoid, now the standard treatment to prevent hyaline membrane disease in premature human beings, might correct the parameters of the pulmonary biochemical and morphologic immaturity in severe congenital diaphragmatic hernia. A total of 112 fetal rats with or without nitrofen-induced congenital diaphragmatic hernias from 34 pregnancies were treated antenatally with either saline or dexamethasone. Antenatal dexamethasone increased the lung disaturated phosphatidylcholine content, reduced the lung glycogen concentration, reduced the saccular septal thickness, and increased the mean saccular size and volume fraction of saccules in the lungs of rats with large congenital diaphragmatic hernia in comparison with similar rats not so treated. All differences were statistically significant. Antenatal glucocorticoid therapy was efficacious in treating rats with nitrofen-induced congenital diaphragmatic hernia. This encouraging finding warrants further investigation in a large animal model with surgically created congenital diaphragmatic hernia.
Suen
H C
HC
Pediatric Surgical Research Laboratories, Massachusetts General Hospital, Boston 02114.
Bloch
K D
KD
Donahoe
P K
PK
D000594:Amino Acid Oxidoreductases / Q000235:genetics; D000818:Animals; D000831:Animals, Newborn; D003907:Dexamethasone / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005325:Fetal Organ Maturity / Q000187:drug effects; D015870:Gene Expression; D006548:Hernia, Diaphragmatic / Q000139:chemically induced / Q000196:embryology; D065630:Hernias, Diaphragmatic, Congenital; D008168:Lung / Q000187:drug effects* / Q000196:embryology* / Q000378:metabolism; D008431:Maternal-Fetal Exchange; D019001:Nitric Oxide Synthase; D010647:Phenyl Ethers / Q000633:toxicity; D010713:Phosphatidylcholines / Q000378:metabolism; D011247:Pregnancy; D011510:Proteolipids / Q000235:genetics; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000235:genetics / Q000378:metabolism; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley
D010647:Phenyl Ethers; D010713:Phosphatidylcholines; D011510:Proteolipids; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; D012333:RNA, Messenger; C017463:lecithins, disaturated; D003907:Dexamethasone; D019001:Nitric Oxide Synthase; D000594:Amino Acid Oxidoreductases; C007350:nitrofen