Abstract
Rationale: Bronchopulmonary dysplasia (BPD) is a frequent cause of morbidity in preterm infants that is characterized by prolonged need for ventilatory support in an intensive care environment. BPD is characterized histopathologically by persistently thick, cellular distal airspace walls. In normally developing lungs, by comparison, remodeling of the immature parenchymal architecture is characterized by thinning of the future alveolar walls, a process predicated on cell loss through apoptosis. Objectives:We hypothesized that minimizing lung injury, using high-frequency nasal ventilation to provide positive distending pressure with minimal assisted tidal volume displacement, would increase apoptosis and decrease proliferation among mesenchymal cells in the distal airspace walls compared with a conventional mode of support (intermittent mandatory ventilation). Methods: Accordingly, we compared two groups of preterm lambs: one group managed by high-frequency nasal ventilation and a second group managed by intermittent mandatory ventilation. Each group was maintained for 3 days. Measurements and Main Results: Oxygenation and ventilation targets were sustained with lower airway pressures and less supplemental oxygen in the high-frequency nasal ventilation group, in which alveolarization progressed. Thinning of the distal airspace walls was accompanied by more apoptosis, and less proliferation, among mesenchymal cells of the high-frequency nasal ventilation group, based on morphometric, protein abundance, and mRNA expression indices of apoptosis and proliferation. Conclusions: Our study shows that high-frequency nasal ventilation preserves the balance between mesenchymal cell apoptosis and proliferation in the distal airspace walls, such that alveolarization progresses.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 407-418 |
| Number of pages | 12 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 178 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 15 2008 |
| Externally published | Yes |
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Keywords
- Alveolar formation
- Bronchopulmonary dysplasia
- Chronic lung disease of prematurity
- Morphometry
- Stereology
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
Cite this
Nasal ventilation alters mesenchymal cell turnover and improves alveolarization in preterm lambs. / Reyburn, Brent; Li, Marlana; Metcalfe, Drew B.; Kroll, Nicholas J.; Alvord, Jeremy; Wint, Albert; Dahl, Mar Janna; Sun, Jiancheng; Dong, Li; Wang, Zheng Ming; Callaway, Christopher; McKnight, Robert A.; Moyer-Mileur, Laurie; Yoder, Bradley A.; Null, Donald; Lane, Robert H.; Albertine, Kurt H.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 178, No. 4, 15.08.2008, p. 407-418.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Nasal ventilation alters mesenchymal cell turnover and improves alveolarization in preterm lambs
AU - Reyburn, Brent
AU - Li, Marlana
AU - Metcalfe, Drew B.
AU - Kroll, Nicholas J.
AU - Alvord, Jeremy
AU - Wint, Albert
AU - Dahl, Mar Janna
AU - Sun, Jiancheng
AU - Dong, Li
AU - Wang, Zheng Ming
AU - Callaway, Christopher
AU - McKnight, Robert A.
AU - Moyer-Mileur, Laurie
AU - Yoder, Bradley A.
AU - Null, Donald
AU - Lane, Robert H.
AU - Albertine, Kurt H.
PY - 2008/8/15
Y1 - 2008/8/15
N2 - Rationale: Bronchopulmonary dysplasia (BPD) is a frequent cause of morbidity in preterm infants that is characterized by prolonged need for ventilatory support in an intensive care environment. BPD is characterized histopathologically by persistently thick, cellular distal airspace walls. In normally developing lungs, by comparison, remodeling of the immature parenchymal architecture is characterized by thinning of the future alveolar walls, a process predicated on cell loss through apoptosis. Objectives:We hypothesized that minimizing lung injury, using high-frequency nasal ventilation to provide positive distending pressure with minimal assisted tidal volume displacement, would increase apoptosis and decrease proliferation among mesenchymal cells in the distal airspace walls compared with a conventional mode of support (intermittent mandatory ventilation). Methods: Accordingly, we compared two groups of preterm lambs: one group managed by high-frequency nasal ventilation and a second group managed by intermittent mandatory ventilation. Each group was maintained for 3 days. Measurements and Main Results: Oxygenation and ventilation targets were sustained with lower airway pressures and less supplemental oxygen in the high-frequency nasal ventilation group, in which alveolarization progressed. Thinning of the distal airspace walls was accompanied by more apoptosis, and less proliferation, among mesenchymal cells of the high-frequency nasal ventilation group, based on morphometric, protein abundance, and mRNA expression indices of apoptosis and proliferation. Conclusions: Our study shows that high-frequency nasal ventilation preserves the balance between mesenchymal cell apoptosis and proliferation in the distal airspace walls, such that alveolarization progresses.
AB - Rationale: Bronchopulmonary dysplasia (BPD) is a frequent cause of morbidity in preterm infants that is characterized by prolonged need for ventilatory support in an intensive care environment. BPD is characterized histopathologically by persistently thick, cellular distal airspace walls. In normally developing lungs, by comparison, remodeling of the immature parenchymal architecture is characterized by thinning of the future alveolar walls, a process predicated on cell loss through apoptosis. Objectives:We hypothesized that minimizing lung injury, using high-frequency nasal ventilation to provide positive distending pressure with minimal assisted tidal volume displacement, would increase apoptosis and decrease proliferation among mesenchymal cells in the distal airspace walls compared with a conventional mode of support (intermittent mandatory ventilation). Methods: Accordingly, we compared two groups of preterm lambs: one group managed by high-frequency nasal ventilation and a second group managed by intermittent mandatory ventilation. Each group was maintained for 3 days. Measurements and Main Results: Oxygenation and ventilation targets were sustained with lower airway pressures and less supplemental oxygen in the high-frequency nasal ventilation group, in which alveolarization progressed. Thinning of the distal airspace walls was accompanied by more apoptosis, and less proliferation, among mesenchymal cells of the high-frequency nasal ventilation group, based on morphometric, protein abundance, and mRNA expression indices of apoptosis and proliferation. Conclusions: Our study shows that high-frequency nasal ventilation preserves the balance between mesenchymal cell apoptosis and proliferation in the distal airspace walls, such that alveolarization progresses.
KW - Alveolar formation
KW - Bronchopulmonary dysplasia
KW - Chronic lung disease of prematurity
KW - Morphometry
KW - Stereology
UR - http://www.scopus.com/inward/record.url?scp=48949083712&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=48949083712&partnerID=8YFLogxK
U2 - 10.1164/rccm.200802-359OC
DO - 10.1164/rccm.200802-359OC
M3 - Article
C2 - 18556628
AN - SCOPUS:48949083712
VL - 178
SP - 407
EP - 418
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 4
ER -