title: Upregulation of keratinocyte growth factor in the tracheal ligation lamb model of congenital diaphragmatic hernia.
abstract: OBJECTIVE
  Congenital diaphragmatic hernia (CDH) carries a high mortality rate of 60% because of associated anomalies, pulmonary hypoplasia, pulmonary hypertension, and type II cell dysfunction. Prenatal tracheal ligation has been shown to improve lung growth in experimental models. This could be caused by a direct effect of increased endothoracic pressure in utero, secondary to the induction of specific growth factors, or both. Keratinocyte growth factor (KGF) is involved in normal lung organogenesis and is a potent mitogen of alveolar type II cells. The authors have therefore investigated the protein and mRNA levels of keratinocyte growth factor in the lung tissue of control, CDH, and CDH tracheal ligation lambs.
  
  
  METHODS
  Eight lambs had left-sided diaphragmatic hernias surgically created at 80 days' gestation. Tracheal ligation was performed at 110 days in 4 lambs, and they were delivered by cesarean section at 140 to 145 days. Twin littermates served as controls. The lungs were dissected en bloc and snap frozen. KGF protein levels were determined by ELISA. Total RNA was isolated, and a RNase protection assay was performed using an ovine cDNA probe for KGF, and a human cDNA probe for GAPDH (house keeping control). Densitometric analysis was used to quantify the relative amounts of mRNA in each sample.
  
  
  RESULTS
  There was a significant decrease in the KGF protein levels of the CDH samples (110 v 73.2 pg/mg protein, P =.02). This decrease was mirrored by a significant fall in the level of mRNA expression for KGF (0.694 v 0.235, P = .02). Tracheal ligation normalized the KGF protein levels (96.1 pg/mg protein). This elevation of KGF protein was accompanied by an upregulation of KGF gene expression to control levels (0.56).
  
  
  CONCLUSIONS
  Tracheal ligation clearly is accompanied by an upregulation of keratinocyte growth factor protein and gene expression. It is not yet clear whether keratinocyte growth factor is solely responsible for the growth observed in these tracheal ligation preparations. Further growth factor blocking experiments are required.
authors.affiliation: Buffalo Institute of Fetal Therapy (BIFT), The Children's Hospital of Buffalo (Kaleida Health), Departments of Surgery, The State University of New York at Buffalo, School of Medicine and Biomedical Sciences, NY,USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: McCabe
authors.forename: U
authors.initials: U
authors.lastname: Carlino
authors.forename: B A
authors.initials: BA
authors.lastname: Holm
authors.forename: P L
authors.initials: PL
authors.lastname: Glick
mesh_terms: D000818:Animals; D005260:Female; D051526:Fibroblast Growth Factor 10; D051523:Fibroblast Growth Factor 7; D005346:Fibroblast Growth Factors; D015870:Gene Expression; D006133:Growth Substances / Q000235:genetics / Q000378:metabolism*; D006548:Hernia, Diaphragmatic / Q000378:metabolism*; D065630:Hernias, Diaphragmatic, Congenital; D008168:Lung / Q000166:cytology / Q000196:embryology* / Q000378:metabolism*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D012333:RNA, Messenger / Q000378:metabolism; D012756:Sheep; D014132:Trachea / Q000601:surgery*; D015854:Up-Regulation
chemical_list: D051526:Fibroblast Growth Factor 10; D006133:Growth Substances; D012333:RNA, Messenger; D051523:Fibroblast Growth Factor 7; D005346:Fibroblast Growth Factors