Abstract
Obstruction of the fetal trachea is a potent stimulus for fetal lung growth and may have therapeutic potential in human fetuses with lung hypoplasia. However, the effects of increased lung expansion on lung development near midgestation, which is the preferred timing for fetal intervention, have not been well studied. Our aim was to determine the effects of increased lung expansion on lung development at 75–90 d of gestation in fetal sheep. In three groups of fetuses (n = 4 for each), the trachea was occluded for either 10 [10-d tracheal occlusion (TO) group] or 15 d (15-d TO group) or left intact (control fetuses). TO for both 10 and 15 d caused fetal hydrops, resulting in significantly increased fetal body weights. Both periods of TO significantly increased total lung DNA contents from 99.8 ± 10.1 to 246.0 ± 5.3 and 246.9 ± 48.7 mg in 10- and 15-d TO fetuses, respectively. TO for 10 and 15 d also increased airspace diameter, although the percentage of lung occupied by airspace was not increased in 10-d TO fetuses due to large increases in interairway distances; this resulted from a large increase in mesenchymal tissue. The interairway distances at 15 d of TO were reduced compared with the 10-d value but were still ∼30% larger than control values. We conclude that TO at <90 d of gestation in fetal sheep induces a greater increase in lung tissue growth than later in gestation but also causes fetal hydrops and produces changes in lung structure that are not compatible with efficient gas exchange. Thus, increased lung expansion at a similar stage of development in human fetuses is unlikely to induce changes in lung development that would facilitate gas exchange after birth.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- TO:
-
tracheal occlusion
- PAS:
-
periodic acid-Schiff
- GA:
-
gestational age
- Sao2:
-
percentage oxygen saturation of Hb
References
Hooper SB, Harding R 1995 Fetal lung liquid: a major determinant of the growth and functional development of the fetal lung. Clin Exp Pharmacol Physiol 22: 235–247
Alcorn D, Adamson TM, Lambert TF, Maloney JE, Ritchie BC, Robinson PM 1977 Morphological effects of chronic tracheal ligation and drainage in the fetal lamb lung. J Anat 123: 649–660
Moessinger AC, Harding R, Adamson TM, Singh M, Kiu GT 1990 Role of lung fluid volume in growth and maturation of the fetal sheep lung. J Clin Invest 86: 1270–1277
Hooper SB, Han VKM, Harding R 1993 Changes in lung expansion alter pulmonary DNA synthesis and IGF-II gene expression in fetal sheep. Am J Physiol 265: L403–L409
Nardo L, Hooper SB, Harding R 1998 Stimulation of lung growth by tracheal obstruction in fetal sheep: relation to luminal pressure and lung liquid volume. Pediatr Res 43: 184–190
Nardo L, Maritz G, Harding R, Hooper SB 2000 Changes in lung structure and cellular division induced by tracheal obstruction in fetal sheep. Exp Lung Res 26: 105–119
Bealer JF, Skarsgard ED, Hedrick MH, Meuli M, Vanderwall KJ, Flake AW, Adzick NS, Harrison MR 1995 The ‘PLUG' odyssey: adventures in experimental fetal tracheal occlusion. J Pediatr Surg 30: 361–365
Hedrick MH, Estes JM, Sullivan KM, Bealer JF, Kitterman JA, Flake AW, Adzick NS, Harrison MR 1994 Plug the lung until it grows (PLUG): a new method to treat congenital diaphragmatic hernia in utero. J Pediatr Surg 29: 612–617
Nardo L, Hooper SB, Harding R 1995 Lung hypoplasia can be reversed by short-term obstruction of the trachea in fetal sheep. Pediatr Res 38: 690–696
Wilson JM, DiFiore JW, Peters CA 1993 Experimental fetal tracheal ligation prevents the pulmonary hypoplasia associated with fetal nephrectomy: possible application for congenital diaphragmatic hernia. J Pediatr Surg 28: 1433–1440
Harrison MR, Adzick NS, Flake AW, Vanderwall KJ, Bealer JF, Howell LJ, Farrell JA, Rosen MA, Sola A, Goldberg JD 1996 Correction of congenital diaphragmatic hernia in utero. J Pediatr Surg 31: 1339–1348
Graf JL, Gibbs DL, Adzick NS, Harrison MR 1997 Fetal hydrops after in utero tracheal occlusion. J Pediatr Surg 32: 214–216
Vanderwall KJ, Skarsgard ED, Filly RA, Eckert J, Harrison MR 1997 Fetendo-clip: a fetal endoscopic tracheal clip procedure in a human fetus. J Pediatr Surg 32: 970–972
Keramidaris E, Hooper SB, Harding R 1996 Effect of gestational age on the increase in fetal lung growth following tracheal obstruction. Exp Lung Res 22: 283–298
Lipsett J, Cool JC, Runciman SC, Ford WDA, Kennedy JD, Martin AJ, Parsons DW 1998 Effect of antenatal tracheal occlusion on lung development in the sheep model of congenital diaphragmatic hernia: a morphological analysis of pulmonary structure and maturity. Pediatr Pulmonol 25: 257–269
Weibel ER 1963 Morphometry of the Human Lung. Springer-Verlag, Berlin
Alcorn DG, Adamson TM, Maloney JE, Robinson PM 1981 A morphologic and morphometric analysis of fetal lung development in the sheep. Anat Rec 201: 655–667
Joe P, Wallen LD, Chapin CJ, Lee CH, Allen L, Han VKM, Dobbs LG, Hawgood S, Kitterman JA 1997 Effects of mechanical factors on growth and maturation of the lung in fetal sheep. Am J Physiol 16: L95–L105
Boland RE, Nardo L, Hooper SB 1997 Cortisol pretreatment enhances the lung growth response to tracheal obstruction in fetal sheep. Am J Physiol 273: L1126–L1131
DiFiore JW, Fauza DO, Slavin R, Peters CA, Fackler JC, Wilson JM 1994 Experimental fetal tracheal ligation reverses the structural and physiological effects of pulmonary hypoplasia in congenital diaphragmatic hernia. J Pediatr Surg 29: 248–257
De Paepe ME, Johnson BD, Papadakis K, Sueishi K, Luks FI 1998 Temporal pattern of accelerated lung growth after tracheal occlusion in the fetal rabbit. Am J Pathol 152: 179–190
De Paepe ME, Papadakis K, Johnson BD, Luks FI 1998 Fate of the type II pneumocyte following tracheal occlusion in utero : a time-course study in fetal sheep. Virchows Arch 432: 7–16
Acknowledgements
The authors thank Alex Satragno, Alison Thiel, and Ian Boundy for their assistance in surgical and histologic techniques.
Author information
Authors and Affiliations
Additional information
Supported by the National Health and Medical Research Council of Australia.
Rights and permissions
About this article
Cite this article
Probyn, M., Wallace, M. & Hooper, S. Effect of Increased Lung Expansion on Lung Growth and Development Near Midgestation in Fetal Sheep. Pediatr Res 47, 806–812 (2000). https://doi.org/10.1203/00006450-200006000-00021
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/00006450-200006000-00021
This article is cited by
-
Comparative analysis of the mechanical signals in lung development and compensatory growth
Cell and Tissue Research (2017)