Antenatal vitamin A decreases ventilation-induced lung injury in the lamb model of congenital diaphragmatic hernia.
OBJECTIVE
Infants with congenital diaphragmatic hernia (CDH) are susceptible to ventilation-induced lung injury. Vitamin A may protect the lung from injury during ventilation. The authors investigated the effects of antenatal vitamin A on ventilation-induced lung injury in CDH lambs using lung myeloperoxidase (MPO) activity as an indicator of lung injury.


METHODS
Left-sided diaphragmatic defects were created in 10 lambs at 79-81 days' gestation. Six CDH lambs had right jugular venous catheters inserted at 120 days' gestation and were given vitamin A until 135 days' gestation. Four CDH lambs were not treated. Twin littermates (n = 3) served as controls. All lambs were delivered at 136-139 days of gestation and ventilated for 2 hours. Lambs were sacrificed following ventilation and samples of left lung were snap frozen. MPO was extracted from lung tissue and MPO activity was assayed.


RESULTS
CDH lambs treated with antenatal vitamin A demonstrated significantly lower MPO activity than untreated CDH lambs (0.0477 +/- 0.0150 vs. 0.1106 +/- 0.0230 units/mg protein, p < 0.05).


CONCLUSIONS
This is the first study to look at the effect of vitamin A on lung injury in CDH. In the lamb model of CDH, antenatal vitamin A decreases ventilation-induced lung injury.
Lewis
Nicola A
NA
The Buffalo Institute of Fetal Therapy, Children's Hospital of Buffalo, New York, USA. nicola_lewis@msn.com
Holm
Bruce A
BA
Swartz
Daniel
D
Sokolowski
June
J
Rossman
Jon
J
Glick
Philip L
PL
D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D005260:Female; D006548:Hernia, Diaphragmatic / Q000150:complications; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011295:Prenatal Care; D012121:Respiration, Artificial / Q000009:adverse effects*; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology / Q000517:prevention & control*; D012756:Sheep; D014801:Vitamin A / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage*
D014815:Vitamins; D014801:Vitamin A