Randomized trials indicate vitamin A (VA) supplementation decreases bronchopulmonary dysplasia or death in extremely premature infants. It is important to understand the mechanisms by which VA and its derivative retinoic acid (RA) prevent or reverse lung injury.
Aims
The hypothesis was that newborn C57BL/6 mice administered VA in combination with RA would reduce hyperoxic lung injury and increase lung retinyl ester (RE) content as compared to animals administered VA, RA, or vehicle alone (canola oil).
Methods
Newborn C57BL/6 mice were exposed to 95% O2 or room air from birth and sacrificed at 4 days of age. The agent (VA, RA or the combination VARA)/vehicle was given orally daily. Lungs were evaluated for lung injury (epithelial damage and hemorrhage) by a masked observer, and RE were measured by HPLC in the lung and liver.
Results
Hyperoxia led to lung injury, which was reduced more by VARA than by either VA or RA alone (Figure). Epithelial damage and hemorrhage correlated well with each other (r = .94, p < .001). RE levels increased more with VARA than by VA or RA alone (data not shown).
Conclusions
Retinoids reduce hyperoxic lung injury in newborn mice. The combination of VA and RA may have synergistic effects on tissue retinoid levels.
Hypoxia enhances transforming growth factor-β (TGF-β) signaling, inhibiting alveolar development and causing abnormal pulmonary arterial remodeling in the newborn lung. We hypothesized that, during chronic hypoxia, reduced peroxisome proliferator-activated receptor-γ (PPAR-γ) signaling may contribute to, or be caused by, excessive TGF-β signaling. To determine whether PPAR-γ was reduced during hypoxia, C57BL/6 mice were exposed to hypoxia from birth to 2 wk and evaluated for PPAR-γ mRNA and protein. To determine whether rosiglitazone (RGZ, a PPAR-γ agonist) supplementation attenuated the effects of hypoxia, mice were exposed to air or hypoxia from birth to 2 wk in combination with either RGZ or vehicle, and measurements of lung histology, function, parameters related to TGF-β signaling, and collagen content were made. To determine whether excessive TGF-β signaling reduced PPAR-γ, mice were exposed to air or hypoxia from birth to 2 wk in combination with either TGF-β-neutralizing antibody or vehicle, and PPAR-γ signaling was evaluated. We observed that hypoxia reduced PPAR-γ mRNA and protein, in association with impaired alveolarization, increased TGF-β signaling, reduced lung compliance, and increased collagen. RGZ increased PPAR-γ signaling, with improved lung development and compliance in association with reduced collagen and TGF-β signaling. However, no reduction was noted in hypoxia-induced pulmonary vascular remodeling. Inhibition of hypoxia-enhanced TGF-β signaling increased PPAR-γ signaling. These results suggest that hypoxia-induced inhibition of lung development is associated with a mutually antagonistic relationship between reduced PPAR-γ and increased TGF-β signaling. PPAR-γ agonists may be of potential therapeutic significance in attenuating TGF-β signaling and improving alveolar development.
Levcromakalim (LKM; a K(ATP) channel opener) reverses hypoxic pulmonary vasoconstriction in isolated pulmonary arteries and perfused lungs. This vasorelaxation is blocked by glibenclamide (GLB; a K(ATP) channel blocker). We evaluated the hemodynamic effect of LKM followed by GLB in a chronically instrumented neonatal porcine model of pulmonary hypertension, created by exposing piglets to hypoxia (n = 7) or heat-killed group B streptococci (GBS) (n = 6). Hypoxia increased pulmonary arterial pressure (PAP), which LKM decreased, and GLB subsequently increased in a dose-dependent manner. Systemic arterial pressure (SAP) did not change with hypoxia but was also decreased by LKM and increased by GLB. GBS also led to increased PAP, but LKM significantly reduced only SAP, which was then increased by GLB. We conclude LKM is capable of reversing hypoxic, but not GBS-induced, pulmonary hypertension but lacks specificity for the neonatal pulmonary vasculature.
We have previously shown that inhibition of transforming growth factor-β (TGF-β) signaling attenuates hypoxia-induced inhibition of alveolar development and abnormal pulmonary vascular remodeling in the newborn mice and that endothelin-A receptor (ETAR) antagonists prevent and reverse the vascular remodeling. The current study tested the hypothesis that inhibition of TGF-β signaling attenuates endothelin-1 (ET-1) expression and thereby reduces effects of hypoxia on the newborn lung. C57BL/6 mice were exposed from birth to 2 wk of age to either air or hypoxia (12% O(2)) while being given either BQ610 (ETAR antagonist), BQ788 (ETBR antagonist), 1D11 (TGF-β neutralizing antibody), or vehicle. Lung function and development and TGF-β and ET-1 synthesis were assessed. Hypoxia inhibited alveolar development, decreased lung compliance, and increased lung resistance. These effects were associated with increased TGF-β synthesis and signaling and increased ET-1 synthesis. BQ610 (but not BQ788) improved lung function, without altering alveolar development or increased TGF-β signaling in hypoxia-exposed animals. Inhibition of TGF-β signaling reduced ET-1 in vivo, which was confirmed in vitro in mouse pulmonary endothelial, fibroblast, and epithelial cells. ETAR blockade improves function but not development of the hypoxic newborn lung. Reduction of ET-1 via inhibition of TGF-β signaling indicates that TGF-β is upstream of ET-1 during hypoxia-induced signaling in the newborn lung.
