title: Metabolomic profile of amniotic fluid to evaluate lung maturity: the diaphragmatic hernia lamb model.
abstract: BACKGROUND
  Tracheal occlusion (TO) stimulates lung growth in fetuses affected with congenital diaphragmatic hernia (CDH) although the processes involved in lung maturation still remain unknown. The objective of this study was to evaluate the metabolomic profile of amniotic fluid (AF) following TO in fetal lamb model in order to obtain an indirect view of mechanisms involved in pulmonary reversal hypoplasia and biochemical maturity in response to fetal TO.
  
  
  METHODS
  Liquid Chromatography Mass Spectrometry was performed on lamb AF samples at: age I (70 days' gestation); age II (102 days' gestation); age III (136 days' gestation). CDH was induced at age I and TO at age II.
  
  
  RESULTS
  Betaine, choline, creatinine were found significantly increased during gestation in the control group. The CDH group showed choline (p =0.007) and creatinine (p =0.004) decreases during pregnancy. In the TO group choline and creatinine profiles were restored.
  
  
  CONCLUSIONS
  Alveolar tissue and fetal global growth ameliorated after TO. Metabolomics provided useful information on biochemical details during lung maturation. Metabolomic profiling would help to identify the best time to perform TO, in order to increase survival of CDH affected patients.
authors.affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia and University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Pelizzo
authors.affiliation: Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ballico
authors.affiliation: Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Mimmi
authors.affiliation: Cincinnati Fetal Center. Pediatric Surgery Division, CCHMC, Cincinnati, OH USA.
authors.forename: José Louis
authors.initials: JL
authors.lastname: Peirò
authors.affiliation: Fetal Surgery Program, Congenital Malformations Research Group, Research Institute of Hospital Universitari Vall d'Hebron, Edifici Infantil, Barcelona, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Marotta
authors.affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia and University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
authors.forename: Costanzo
authors.initials: C
authors.lastname: Federico
authors.affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia and University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Andreatta
authors.affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia and University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Nakib
authors.affiliation: Laboratory of Translational Cardiomyology, Stem Cell Interdepartmental Institute, KU Leuven and Human Anatomy, University of Pavia, Pavia, Italy.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Sampaolesi
authors.affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia and University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Zambaiti
authors.affiliation: Department of the Mother and Child Health, Pediatric Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia and University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy ; Department of Internal Medicine, University of Pavia, Pavia, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Calcaterra
keywords: Amniotic fluid; Animal model; Congenital diaphragmatic hernia; Metabolomic; Tracheal occlusion