title: Inflammation-induced preterm lung maturation: lessons from animal experimentation.
abstract: Intrauterine inflammation, or chorioamnionitis, is a major contributor to preterm birth. Prematurity per se is associated with considerable morbidity and mortality resulting from lung immaturity but exposure to chorioamnionitis reduces the risk of neonatal respiratory distress syndrome (RDS) in preterm infants. Animal experiments have identified that an increase in pulmonary surfactant production by the preterm lungs likely underlies this decreased risk of RDS in infants exposed to chorioamnionitis. Further animal experimentation has shown that infectious or inflammatory agents in amniotic fluid exert their effects on lung development by direct effects within the developing respiratory tract, and probably not by systemic pathways. Differences in the effects of intrauterine inflammation and glucocorticoids demonstrate that canonical glucocorticoid-mediated lung maturation is not responsible for inflammation-induced changes in lung development. Animal experimentation is identifying alternative lung maturational pathways, and transgenic animals and cell culture techniques will allow identification of novel mechanisms of lung maturation that may lead to new treatments for the prevention of RDS.
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia; Department of Obstetrics and Gynecology, Monash University, Clayton, VIC 3168, Australia. Electronic address: tim.moss@monash.edu.
authors.forename: Timothy J M
authors.initials: TJM
authors.lastname: Moss
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC 3168, Australia.
authors.forename: Alana J
authors.initials: AJ
authors.lastname: Westover
mesh_terms: D000818:Animals; D002821:Chorioamnionitis / Q000378:metabolism*; D055808:Drug Discovery; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000378:metabolism; D006801:Humans; D008168:Lung / Q000254:growth & development / Q000378:metabolism / Q000503:physiopathology; D011014:Pneumonia / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D011453:Prostaglandins / Q000378:metabolism; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control
chemical_list: D005938:Glucocorticoids; D011453:Prostaglandins
keywords: Inflammation; bronchopulmonary dysplasia; glucocorticoids; preterm; prostaglandins; respiratory distress syndrome; surfactant