Vilos G A, Challis J R, Lye S J, Possmayer F, Harding P G
J Dev Physiol. 1983 Oct;5(5):341-50.
The role of Adrenocorticotrophin (ACTH), administered in physiological doses (12 micrograms/d), on lung maturation was investigated in the intact ovine fetus at 127-130 days of gestation. ACTH1-24 was administered in a pulsatile or continuous dose for 72 hours. Compared to untreated twins (n = 4) and saline infused fetuses (n = 4), the lungs of the pulsatile-ACTH (n = 10) and continuous-ACTH (n = 4) treated fetuses showed accelerated prepartum maturation by all indices used. Lung distensibility (V40-ml of air per g of wet lung at 40 cm H2O pressure), as determined by pressure-volume curves with air was 1.62 +/- 0.18 vs 0.72 +/- 0.23 and 0.66 +/- 0.12 while the stability (Vo-ml of air per g of wet lung at atmospheric pressure) was 0.33 +/- 0.07 vs 0.10 +/- 0.01 and 0.21 +/- 0.09 for the P-ACTH group vs the control groups (P less than 0.005). In the continuous-ACTH group vs their untreated twins the distensibility was 1.58 +/- 0.10 vs 0.56 +/- 0.11 while the stability was 0.83 +/- 0.20 vs 0.09 +/- 0.01 respectively (less than 0.005). Phosphotidylcholine concentration in lavage fluid increased from 0.05 +/- 0.02 mg/g of lung to 0.24 +/- 0.07 in the pulsed-ACTH group compared to untreated twin fetuses (P less than 0.05). Morphologically the lungs of the treated groups were well aerated with thin walled airsacs. In both treated groups, there was a doubling of the adrenal weight (P less than 0.005). Fetal plasma cortisol basal level increased from less than 5 ng/ml to 143.5 +/- 66.5 ng/ml in the continuous-ACTH group while it only rose to 36.6 +/- 7.5 ng/ml in the pulsed-ACTH group by 72 hours. Superimposed on the rise in basal fetal cortisol, there was an acute increase in cortisol temporally related to each ACTH pulse; the peaks reaching levels indistinguishable from the levels of the continuous-ACTH infusion. It is concluded that the administration of low doses of ACTH markedly accelerate prepartum maturation of the intact ovine lung over 72 hours. The mechanism by which ACTH exerts this powerful maturation effect on the fetal lung remains to be elucidated.
在妊娠127 - 130天的完整绵羊胎儿中，研究了生理剂量（12微克/天）的促肾上腺皮质激素（ACTH）对肺成熟的作用。以脉冲或持续剂量给予促肾上腺皮质激素1 - 24，持续72小时。与未治疗的双胞胎（n = 4）和输注生理盐水的胎儿（n = 4）相比，接受脉冲ACTH（n = 10）和持续ACTH（n = 4）治疗的胎儿的肺，根据所使用的所有指标显示产前成熟加速。通过空气压力 - 容积曲线测定的肺扩张性（在40 cm H₂O压力下每克湿肺的V40 - 空气毫升数），脉冲ACTH组为1.62±0.18，而未治疗的双胞胎组为0.72±0.23，输注生理盐水组为0.66±0.12；而稳定性（在大气压下每克湿肺的Vo - 空气毫升数），脉冲ACTH组为0.33±0.07，对照组分别为0.10±0.01和0.21±0.09（P＜0.005）。在持续ACTH组与其未治疗的双胞胎相比，扩张性为1.58±0.10，而对照组为0.56±0.11，稳定性分别为0.83±0.20和0.09±0.01（＜0.005）。与未治疗的双胞胎胎儿相比，脉冲ACTH组灌洗液中磷脂酰胆碱浓度从0.05±0.02毫克/克肺增加到0.24±0.07（P＜0.05）。形态学上，治疗组的肺充气良好，气囊壁薄。在两个治疗组中，肾上腺重量增加了一倍（P＜0.005）。持续ACTH组胎儿血浆皮质醇基础水平从低于5纳克/毫升增加到143.5±66.5纳克/毫升，而脉冲ACTH组在72小时时仅升至36.6±7.5纳克/毫升。在基础胎儿皮质醇升高的基础上，与每个ACTH脉冲在时间上相关的皮质醇有急性增加；峰值达到与持续ACTH输注水平难以区分的水平。结论是，低剂量ACTH的给药在72小时内显著加速完整绵羊肺的产前成熟。ACTH对胎儿肺发挥这种强大成熟作用的机制仍有待阐明。
