Lung growth factors in the amniotic fluid of normal pregnancies and with congenital diaphragmatic hernia.
OBJECTIVE
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 β (TGFβ) 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 TGFβ was still decreased. Same GFs were similarly expressed in both lungs of babies dead of CDH.


CONCLUSIONS
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.
a University of Trieste , Trieste , Italy .
Vanessa
V
Candilera
b Department of Gynecology , and.
Carlo
C
Bouchè
c Pediatric Surgery, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" , Trieste , Italy.
Jurgen
J
Schleef
c Pediatric Surgery, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" , Trieste , Italy.
Federica
F
Pederiva
D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis / Q000378:metabolism*; D008168:Lung / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D055815:Young Adult
D036341:Intercellular Signaling Peptides and Proteins
Growth factors; lung development; pulmonary hypoplasia