Wickman D S, Siebert J R, Benjamin D R
Department of Laboratories, Children's Hospital and Medical Center, Seattle, Washington 98105.
Teratology. 1993 Feb;47(2):119-25. doi: 10.1002/tera.1420470204.
In previous clinical reports, we have documented the association of several morphologic changes with congenital diaphragmatic hernia or, perhaps more appropriately termed, congenital diaphragmatic defect (CDD). These anomalies include decreased cardiac mass with left ventricular hypoplasia in infants with left-sided CDDs (Siebert et al., '84), enlarged, asymmetric chests (Siebert and Benjamin, '87), and extrathoracic anomalies (Benjamin et al., '88), including urinary tract anomalies and elevated kidney weights in otherwise normal kidneys (Glick et al., '90; Siebert et al., '90). Hypoplastic lungs and hearts and enlarged chests are thought to result from the herniation of abdominal viscera into the thoracic cavity, but for the renal abnormalities, pathogenesis is unclear. The findings are intriguing, for they could mirror unrecognized developmental relationships between the diaphragm, lung, heart, and kidney. In order to further examine these issues and to test the applicability of experimentally produced CDDs to human disease, we administered nitrofen (2,4-dichlorophenyl-p-nitrophenyl ether), an herbicide known to produce diaphragmatic defects in rodents, to time-mated CD1 mice by gavage feeding on gestational days 8 and 9. Dosages were 200 (low dose) or 500 (high dose) mg/kg body weight, and fetuses were studied on gestational day 18. Diaphragmatic defects occurred in a dose-response fashion: 0% (0/48) control or sham-fed, 5% (5/104) in the low-dose group, and 25% (19/75) in the high-dose group. Several fetuses with cleft palate, renal agenesis, exencephaly/encephalocele, and/or Di-George sequence were noted at the high dose, the latter a previously undescribed finding. Diaphragmatic defects were primarily right sided and only associated with herniation of abdominal viscera in animals exposed to 500 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS)
在先前的临床报告中,我们记录了几种形态学改变与先天性膈疝的关联,或者更恰当的说法是先天性膈缺损(CDD)。这些异常包括左侧CDD婴儿中心脏质量下降伴左心室发育不全(西伯特等人,1984年)、胸廓增大且不对称(西伯特和本杰明,1987年)以及胸外异常(本杰明等人,1988年),包括泌尿系统异常以及在其他方面正常的肾脏中肾重量增加(格利克等人,1990年;西伯特等人,1990年)。肺和心脏发育不全以及胸廓增大被认为是由于腹腔脏器疝入胸腔所致,但对于肾脏异常,其发病机制尚不清楚。这些发现很有趣,因为它们可能反映了膈肌、肺、心脏和肾脏之间未被认识的发育关系。为了进一步研究这些问题并测试实验性产生的CDD对人类疾病的适用性,我们在妊娠第8天和第9天通过灌胃给定时交配的CD1小鼠施用了硝呋烯腙(2,4 - 二氯苯基 - p - 硝基苯基醚),一种已知会在啮齿动物中产生膈缺损的除草剂。剂量为200(低剂量)或500(高剂量)毫克/千克体重,并在妊娠第18天对胎儿进行研究。膈缺损呈剂量反应方式出现:对照组或假喂养组为0%(0/48),低剂量组为5%(5/104),高剂量组为25%(19/75)。在高剂量组中发现了几只患有腭裂、肾缺如、无脑儿/脑膨出和/或迪格奥尔格综合征的胎儿,后者是一个先前未描述的发现。膈缺损主要在右侧,并且仅与暴露于500毫克/千克的动物中的腹腔脏器疝出有关。(摘要截取自250字)