Scheepens Arjan, van de Waarenburg Marjo, van den Hove Daniël, Blanco Carlos E
Department of Pediatrics, GROW Research Institute, University of Maastricht, 6202 AZ Maastricht, The Netherlands.
J Physiol. 2003 Oct 1;552(Pt 1):163-75. doi: 10.1113/jphysiol.2003.043414. Epub 2003 Aug 8.
The aim of this study was to determine the effects of a clinically relevant single course of prenatal betamethasone in the rat on growth parameters with particular reference to brain cell proliferation and apoptosis. We report that administration of 170 microg kg-1 betamethasone twice within 4 h to E20 pregnant rats conveys moderate somatic growth retardation. Further, using a measure of brain cell proliferation independent of blood-brain barrier (BBB) permeability, we demonstrate for the first time that betamethasone is chronically anti-proliferative to brain cells without inducing caspase-3-mediated apoptosis. More importantly we show that there is a significant and sexually divergent rebound of neural proliferation which occurs earlier in males than in females and continues until at least 21 days of postnatal life. BBB permeability to [3H]thymidine was significantly increased by steroid treatment re-iterating the fact that tracer studies not correcting for BBB permeability, such as bromodeoxyuridine (BrdU), may be questionable in this type of study. Further, prenatal steroid treatment did not alter postnatal corticosterone levels. In summary we show that prenatal betamethasone conveys significant and long-lasting side effects and that its human clinical application in preterm labour needs more careful consideration as compared to the relative ease with which it is prescribed today.
本研究的目的是确定大鼠孕期单次给予临床相关剂量的倍他米松对生长参数的影响,尤其关注脑细胞增殖和凋亡情况。我们报告称,在妊娠第20天的大鼠4小时内两次给予170微克/千克的倍他米松会导致中度躯体生长迟缓。此外,通过一种独立于血脑屏障(BBB)通透性的脑细胞增殖测量方法,我们首次证明倍他米松对脑细胞具有长期的抗增殖作用,且不会诱导半胱天冬酶-3介导的凋亡。更重要的是,我们发现神经增殖存在显著的性别差异反弹,雄性比雌性出现得更早,且至少持续到出生后21天。类固醇治疗显著增加了血脑屏障对[3H]胸腺嘧啶核苷的通透性,再次强调了在这类研究中,如未校正血脑屏障通透性的示踪剂研究(如溴脱氧尿苷,BrdU)可能存在问题。此外,产前类固醇治疗并未改变产后皮质酮水平。总之,我们表明产前倍他米松会带来显著且持久的副作用,与目前相对容易开具处方相比,其在早产中的临床应用需要更谨慎的考虑。