Human amnion epithelial cells reduce ventilation-induced preterm lung injury in fetal sheep

Objective The objective of the study was to explore whether human amnion epithelial cells (hAECs) can mitigate ventilation-induced lung injury. Study Design An established in utero ovine model of ventilation-induced lung injury was used. At day 110 of gestation, singleton fetal lambs either had sham in utero ventilation (IUV) (n = 4), 12 hours of IUV alone (n = 4), or 12 hours of IUV and hAEC administration (n = 5). The primary outcome, structural lung injury, was assessed 1 week later. Results Compared with sham controls, IUV alone was associated with significant lung injury: increased collagen ( P = .03), elastin ( P = .02), fibrosis ( P = .02), and reduced secondary-septal crests ( P = .009). This effect of IUV was significantly mitigated by the administration of hAECs: less collagen ( P = .03), elastin ( P = .04), fibrosis ( P = .02), normalized secondary-septal crests ( P = .02). The hAECs were immunolocalized within the fetal lung and had differentiated into type I and II alveolar cells. Conclusion The hAECs mitigate ventilation-induced lung injury and differentiated into alveolar cells in vivo.