epidermal-growth-factor and Respiratory-Distress-Syndrome--Newborn

Topics: Animals; Animals, Newborn; Bronchopulmonary Dysplasia; Disease Models, Animal; Epidermal Growth Factor; Fibroblast Growth Factors; Growth Substances; Humans; Infant, Newborn; Lung; Platelet-Derived Growth Factor; Respiratory Distress Syndrome, Newborn; Somatomedins; Transforming Growth Factor alpha; Transforming Growth Factor beta; Vascular Endothelial Growth Factor A

Topics: Biomarkers; Chronic Disease; Endothelial Growth Factors; Epidermal Growth Factor; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Lung Diseases; Lymphokines; Respiratory Distress Syndrome, Newborn; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors

Growth factors important to lung growth and fibrosis have been poorly studied in chronic lung disease (CLD) of prematurity. Epidermal growth factor (EGF) promotes epithelial cell maturation, and vascular endothelial growth factor (VEGF) is important in angiogenesis. The concentration of these growth factors was determined in 111 bronchoalveolar lavage fluid (BALF) samples from 35 ventilated infants: 13 developed CLD (median gestation 27 weeks, birthweight 820 g), 16 developed and recovered from respiratory distress syndrome (RDS) (31 weeks, 1,415 g) and six control infants (33 weeks, 2,075 g) were ventilated for nonpulmonary reasons. At birth, EGF in BALF from the CLD and RDS infants was lower than in the control infants (control versus CLD, 7.3 versus 0.0 pg x mL(-1), p<0.01; control versus RDS, 7.3 versus 5.0, p=0.08). EGF increased in all groups with a more rapid increase in control infants. A close relationship was noted between BALF EGF and gestational age (R=0.73). VEGF was undetectable at birth but increased at a similar rate in all three groups and did not correlate with gestation. In conclusion, these data suggest that epidermal growth factor is closely correlated to gestation and that it may predispose preterm infants to develop chronic lung disease.

Topics: Bronchoalveolar Lavage Fluid; Chronic Disease; Endothelial Growth Factors; Epidermal Growth Factor; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Lymphokines; Male; Protein Isoforms; Respiratory Distress Syndrome, Newborn; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors

Topics: Apgar Score; Asphyxia Neonatorum; Epidermal Growth Factor; Humans; Infant, Newborn; Infant, Premature; Respiration, Artificial; Respiratory Distress Syndrome, Newborn

Topics: Epidermal Growth Factor; Humans; Infant, Newborn; Infant, Premature; Radioimmunoassay; Respiration, Artificial; Respiratory Distress Syndrome, Newborn; Suction; Trachea

Treatment of nonhuman primate fetuses with epidermal growth factor (EGF) results in histologic and biochemical maturation of their lungs. To determine whether these effects improve lung function postnatally, we studied premature rhesus infants delivered at 78% of gestation after in utero treatment with EGF (n = 5) or placebo (n = 5). Indices of lung function during the 4 d of postnatal care included fractional concentration of inspired oxygen, peak inspiratory pressure, ventilator rate, mean airway pressure, arterial to alveolar oxygen tension ratio, and ventilation index. Statistically significant differences were noted in the time courses of these variables between EGF- and placebo-treated infants. The direction of the differences indicated that the EGF-treated infants had less severe lung disease. Surfactant apoprotein A concentration and lecithin to sphingomyelin ratio were both significantly higher in the amniotic fluid of the EGF-treated group, indicating advanced biochemical maturation in this group of animals. Whereas birth weight was not affected by EGF exposure, adrenal and gut weights, standardized for body weight, were increased significantly. Histologic studies showed advanced cellular maturation with increased parenchymal airspace and decreased parenchymal tissue space in the EGF-treated group compared with the control group. We conclude that prenatal exposure to EGF stimulates biochemical and histologic maturation of the lung and markedly attenuates the clinical severity of respiratory disease in this model of simian respiratory distress syndrome.

Topics: Amniotic Fluid; Animals; Animals, Newborn; Epidermal Growth Factor; Female; Fetal Organ Maturity; Fetus; Humans; Infant, Newborn; Lung; Macaca mulatta; Male; Peritoneal Cavity; Pregnancy; Recombinant Proteins; Respiration, Artificial; Respiratory Distress Syndrome, Newborn