Abstract
Background:
Preterm infants having immature lungs often require respiratory support, potentially leading to bronchopulmonary dysplasia (BPD). Conventional BPD rodent models based on mechanical ventilation (MV) present outcome measured at the end of the ventilation period. A reversible intubation and ventilation model in newborn rats recently allowed discovering that different sets of genes modified their expression related to time after MV. In a newborn rat model, the expression profile 48 h after MV was analyzed with gene arrays to detect potentially interesting candidates with an impact on BPD development.
Methods:
Rat pups were injected P4-5 with 2 mg/kg lipopolysaccharide (LPS). One day later, MV with 21 or 60% oxygen was applied during 6 h. Animals were sacrified 48 h after end of ventilation. Affymetrix gene arrays assessed the total gene expression profile in lung tissue.
Results:
In fully treated animals (LPS + MV + 60% O2) vs. controls, 271 genes changed expression significantly. All modified genes could be classified in six pathways: tissue remodeling/wound repair, immune system and inflammatory response, hematopoiesis, vasodilatation, and oxidative stress. Major alterations were found in the MMP and complement system.
Conclusion:
MMPs and complement factors play a central role in several of the pathways identified and may represent interesting targets for BPD treatment/prevention.
Bronchopulmonary dysplasia (BPD) is a chronic lung disease occurring in ~30% of preterm infants born less than 30 wk of gestation (1). Its main risk factors include lung immaturity due to preterm delivery, mechanical ventilation (MV), oxygen toxicity, chorioamnionitis, and sepsis. The main feature is an arrest of alveolar and capillary formation (2). Models trying to decipher genes involved in the pathophysiology of BPD are mainly based on MV and oxygen application to young mammals with immature lungs of different species (3). In newborn rodent models, analyses of lung structure and gene and protein expression are performed for practical reasons directly at the end of MV (4,5,6). However, later appearing changes of gene expression might also have an impact on lung development and the evolution towards BPD and cannot be discovered by such models. Recently, we developed a newborn rat model of MV using an atraumatic (orotracheal) intubation technique that allows the weaning of the newborn animal off anesthesia and MV, the extubation to spontaneous breathing, and therefore allows the evaluation of effects of MV after a ventilation-free period of recovery (7). Indeed, applying this concept of atraumatic intubation by direct laryngoscopy, we recently were able to show significant differences between gene expression changes appearing directly after MV compared to those measured after a ventilation-free interval of 48 h. Immediately after MV, inflammation-related genes showed a transitory modified expression, while another set of more structurally related genes changed their expression only after a delay of 2 d (7). Lung structure, analyzed by conventional 2D histology and also by 3D reconstruction using synchrotron x-ray tomographic microscopy revealed, 48 h after end of MV, a reduced complexity of lung architecture compared to the nonventilated rat lungs, similar to the typical findings in BPD. To extend these observations about late gene expression modifications, we performed with a similar model a full gene expression profile of lung tissue 48 h after the end of MV with either room air or 60% oxygen. Essentially, we measured changes in the expression of genes related to the MMPs and complement system which played a role in many of the six identified mostly affected pathways.
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References
Bäckström E, Lappalainen U, Bry K. Maternal IL-1beta production prevents lung injury in a mouse model of bronchopulmonary dysplasia. Am J Respir Cell Mol Biol 2010;42:149–60.
Coalson JJ. Pathology of bronchopulmonary dysplasia. Semin Perinatol 2006;30:179–84.
Bourbon J, Boucherat O, Chailley-Heu B, Delacourt C. Control mechanisms of lung alveolar development and their disorders in bronchopulmonary dysplasia. Pediatr Res 2005;57(5 Pt 2):38R–46R.
Kroon AA, Wang J, Huang Z, Cao L, Kuliszewski M, Post M. Inflammatory response to oxygen and endotoxin in newborn rat lung ventilated with low tidal volume. Pediatr Res 2010;68:63–9.
Mokres LM, Parai K, Hilgendorff A, et al. Prolonged mechanical ventilation with air induces apoptosis and causes failure of alveolar septation and angiogenesis in lungs of newborn mice. Am J Physiol Lung Cell Mol Physiol 2010;298:L23–35.
Hilgendorff A, Parai K, Ertsey R, et al. Inhibiting lung elastase activity enables lung growth in mechanically ventilated newborn mice. Am J Respir Crit Care Med 2011;184:537–46.
Trummer-Menzi E, Gremlich S, Schittny JC, et al. Evolution of gene expression changes in newborn rats after mechanical ventilation with reversible intubation. Pediatr Pulmonol 2012;47:1204–14.
Nagato AC, Bezerra FS, Lanzetti M, et al. Time course of inflammation, oxidative stress and tissue damage induced by hyperoxia in mouse lungs. Int J Exp Pathol 2012;93:269–78.
Roth-Kleiner M, Ridsdale R, Cao L, et al. Lipopolysaccharide exposure modifies high tidal volume ventilation-induced proinflammatory mediator expression in newborn rat lungs. Pediatr Res 2007;61:191–6.
Masumoto K, de Rooij JD, Suita S, Rottier R, Tibboel D, de Krijger RR. Expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases during normal human pulmonary development. Histopathology 2005;47:410–9.
Tambunting F, Beharry KD, Hartleroad J, Waltzman J, Stavitsky Y, Modanlou HD. Increased lung matrix metalloproteinase-9 levels in extremely premature baboons with bronchopulmonary dysplasia. Pediatr Pulmonol 2005;39:5–14.
Wang Z, Zheng T, Zhu Z, et al. Interferon gamma induction of pulmonary emphysema in the adult murine lung. J Exp Med 2000;192:1587–600.
Harijith A, Choo-Wing R, Cataltepe S, et al. A role for matrix metalloproteinase 9 in IFNγ-mediated injury in developing lungs: relevance to bronchopulmonary dysplasia. Am J Respir Cell Mol Biol 2011;44:621–30.
Buckley S, Warburton D. Dynamics of metalloproteinase-2 and -9, TGF-beta, and uPA activities during normoxic vs. hyperoxic alveolarization. Am J Physiol Lung Cell Mol Physiol 2002;283:L747–54.
Chetty A, Cao GJ, Severgnini M, Simon A, Warburton R, Nielsen HC. Role of matrix metalloprotease-9 in hyperoxic injury in developing lung. Am J Physiol Lung Cell Mol Physiol 2008;295:L584–92.
Sweet DG, Curley AE, Chesshyre E, et al. The role of matrix metalloproteinases -9 and -2 in development of neonatal chronic lung disease. Acta Paediatr 2004;93:791–6.
Ekekezie II, Thibeault DW, Simon SD, et al. Low levels of tissue inhibitors of metalloproteinases with a high matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio are present in tracheal aspirate fluids of infants who develop chronic lung disease. Pediatrics 2004;113:1709–14.
Triebel S, Bläser J, Reinke H, Tschesche H. A 25 kDa alpha 2-microglobulin-related protein is a component of the 125 kDa form of human gelatinase. FEBS Lett 1992;314:386–8.
Yan L, Borregaard N, Kjeldsen L, Moses MA. The high molecular weight urinary matrix metalloproteinase (MMP) activity is a complex of gelatinase B/MMP-9 and neutrophil gelatinase-associated lipocalin (NGAL). Modulation of MMP-9 activity by NGAL. J Biol Chem 2001;276:37258–65.
Capoluongo E, Vento G, Rocchetti S, et al. Mannose-binding lectin polymorphisms and pulmonary outcome in premature neonates: a pilot study. Intensive Care Med 2007;33:1787–94.
Inoue H, Ohga S, Kusuda T, et al. Serum neutrophil gelatinase-associated lipocalin as a predictor of the development of bronchopulmonary dysplasia in preterm infants. Early Hum Dev 2013;89:425–9.
Lafuma C. [Elastases and pulmonary pathologies]. Pathol Biol (Paris) 1988;36:1124–32.
Sandhaus RA, Turino G. Neutrophil elastase-mediated lung disease. COPD 2013;10:Suppl 1:60–3.
Kawabata K, Hagio T, Matsuoka S. The role of neutrophil elastase in acute lung injury. Eur J Pharmacol 2002;451:1–10.
Hilgendorff A, Parai K, Ertsey R, et al. Neonatal mice genetically modified to express the elastase inhibitor elafin are protected against the adverse effects of mechanical ventilation on lung growth. Am J Physiol Lung Cell Mol Physiol 2012;303:L215–27.
Kong MY, Li Y, Oster R, Gaggar A, Clancy JP. Early elevation of matrix metalloproteinase-8 and -9 in pediatric ARDS is associated with an increased risk of prolonged mechanical ventilation. PLoS One 2011;6:e22596.
Cederqvist K, Janer J, Tervahartiala T, et al. Up-regulation of trypsin and mesenchymal MMP-8 during development of hyperoxic lung injury in the rat. Pediatr Res 2006;60:395–400.
Albaiceta GM, Gutierrez-Fernández A, García-Prieto E, et al. Absence or inhibition of matrix metalloproteinase-8 decreases ventilator-induced lung injury. Am J Respir Cell Mol Biol 2010;43:555–63.
Greenlee KJ, Werb Z, Kheradmand F. Matrix metalloproteinases in lung: multiple, multifarious, and multifaceted. Physiol Rev 2007;87:69–98.
Page-McCaw A, Ewald AJ, Werb Z. Matrix metalloproteinases and the regulation of tissue remodelling. Nat Rev Mol Cell Biol 2007;8:221–33.
Khokha R, Murthy A, Weiss A. Metalloproteinases and their natural inhibitors in inflammation and immunity. Nat Rev Immunol 2013;13:649–65.
Löffek S, Schilling O, Franzke CW. Series “matrix metalloproteinases in lung health and disease”: biological role of matrix metalloproteinases: a critical balance. Eur Respir J 2011;38:191–208.
Rodríguez D, Morrison CJ, Overall CM. Matrix metalloproteinases: what do they not do? New substrates and biological roles identified by murine models and proteomics. Biochim Biophys Acta 2010;1803:39–54.
Liu K, Mao YF, Zheng J, et al. SC5b-9-induced pulmonary microvascular endothelial hyperpermeability participates in ventilator-induced lung injury. Cell Biochem Biophys 2013;67:1421–31.
Takahashi K, Saha D, Shattino I, et al. Complement 3 is involved with ventilator-induced lung injury. Int Immunopharmacol 2011;11:2138–43.
Tsai JA, Lund M, Lundell L, Nilsson-Ekdahl K. One-lung ventilation during thoracoabdominal esophagectomy elicits complement activation. J Surg Res 2009;152:331–7.
Smyth GK. Limma: linear models for microarray data. In: Gentleman R, Carey V, Huber W, Irizarry R, Dudoit S, eds. Bioinformatics and Computational Biology Solutions Using R and Bioconductor. New York: Springer, 2005:397–420.
Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B 1995;57:289–300.
Acknowledgements
We thank Keith Harshmann, Sylvain Pradervand, and Otto Hagenbuchle of the Genomic Technologies Facility of the Center for Integrative Genomics of the University of Lausanne for technical support regarding gene array utilization and statistical analysis of the results and Sam Vasilevsky for the critical revision of the manuscript.
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Dénervaud, V., Gremlich, S., Trummer-Menzi, E. et al. Gene expression profile in newborn rat lungs after two days of recovery of mechanical ventilation. Pediatr Res 78, 641–649 (2015). https://doi.org/10.1038/pr.2015.155
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DOI: https://doi.org/10.1038/pr.2015.155


