Nakamura Hiroki, Zimmer Julia, Friedmacher Florian, Puri Prem
Our Lady's Children's Hospital, National Children's Research Centre, Crumlin, Dublin, Ireland.
Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Eur J Pediatr Surg. 2019 Feb;29(1):102-107. doi: 10.1055/s-0038-1675772. Epub 2018 Dec 10.
Persistent pulmonary hypertension (PPH) is a major cause of morbidity and mortality in newborns with congenital diaphragmatic hernia (CDH). PPH is characterized by increased vascular resistance and smooth muscle cell (SMC) proliferation, leading to obstructive changes in the pulmonary vasculature. Nitric oxide (NO), generated by endothelial NO synthase (eNOS), is an important regulator of vascular tone and plays a key role in pulmonary vasodilatation. NO synthase interacting protein (NOSIP), which is strongly expressed by pulmonary SMCs, has recently been identified to reduce the endogenous NO production by interacting with eNOS. We designed this study to investigate the pulmonary vascular expression of NOSIP in the nitrofen-induced CDH model.
Time-mated Sprague Dawley rats received nitrofen or vehicle on gestational day 9 (D9). Fetuses were sacrificed on D21 and lung specimens divided into CDH and control ( = 6 for each group). Quantitative real-time polymerase chain reaction and Western blotting were performed to analyze pulmonary gene and protein expression of NOSIP. Immunofluorescence double staining for NOSIP was combined with a specific SMC marker to evaluate protein expression in the pulmonary vasculature.
Relative messenger ribonucleic acid and protein expression of NOSIP was significantly decreased in nitrofen-exposed CDH lungs compared with controls. Confocal laser scanning microscopy revealed markedly diminished NOSIP immunofluorescence in nitrofen-exposed CDH lungs compared with controls, mainly in the muscular and endothelial components of the pulmonary vasculature.
This study demonstrates for the first time decreased NOSIP expression in the pulmonary vasculature of the nitrofen-induced CDH. These findings suggest that NOSIP underexpression may interfere with NO production, contributing to abnormal vascular remodeling and PPH.
持续性肺动脉高压(PPH)是先天性膈疝(CDH)新生儿发病和死亡的主要原因。PPH的特征是血管阻力增加和平滑肌细胞(SMC)增殖,导致肺血管系统出现阻塞性改变。由内皮型一氧化氮合酶(eNOS)产生的一氧化氮(NO)是血管张力的重要调节因子,在肺血管舒张中起关键作用。最近发现,肺SMC强烈表达的一氧化氮合酶相互作用蛋白(NOSIP)通过与eNOS相互作用来减少内源性NO的产生。我们设计了本研究,以调查在硝呋烯腙诱导的CDH模型中NOSIP在肺血管中的表达。
在妊娠第9天(D9),将同期受孕的Sprague Dawley大鼠分为两组,分别给予硝呋烯腙或赋形剂。在D21处死胎儿,将肺标本分为CDH组和对照组(每组6只)。采用定量实时聚合酶链反应和蛋白质印迹法分析肺组织中NOSIP的基因和蛋白表达。将NOSIP免疫荧光双重染色与特异性SMC标记物结合,以评估肺血管中蛋白的表达。
与对照组相比,硝呋烯腙暴露的CDH肺组织中NOSIP的相对信使核糖核酸和蛋白表达显著降低。共聚焦激光扫描显微镜显示,与对照组相比,硝呋烯腙暴露的CDH肺组织中NOSIP免疫荧光明显减弱,主要在肺血管的肌肉和内皮成分中。
本研究首次证明在硝呋烯腙诱导的CDH肺血管中NOSIP表达降低。这些发现表明,NOSIP表达不足可能会干扰NO的产生,导致血管重塑异常和PPH。