Lung injury after asphyxia and hemorrhagic shock in newborn piglets: Analysis of structural and inflammatory changes

• Published in: PloS one Vol. 14; no. 7; p. e0219211
• Main Authors: Weber, Birte, Mendler, Marc Robin, Lackner, Ina, von Zelewski, Alexander, Höfler, Severin, Baur, Meike, Braun, Christian Karl, Hummler, Helmut, Schwarz, Stephan, Pressmar, Jochen, Kalbitz, Miriam
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 05.07.2019; Public Library of Science (PLoS)
• Subjects: Animals; Animals, Newborn - metabolism; Asphyxia; Asphyxia - physiopathology; Asphyxia neonatorum; Asphyxia Neonatorum - metabolism; Asphyxia Neonatorum - physiopathology; Behavior; Biology and Life Sciences; Blood; Blood circulation; Blood transfusion; Cell Adhesion Molecules - metabolism; Claudins - metabolism; Complications and side effects; Connexin 43; Connexin 43 - metabolism; Critical care; Cytokines; Disease Models, Animal; Edema; EDTA; Gap Junctions; Gene expression; Hemorrhage; Hemorrhagic shock; Hogs; Hypoxia; Immunology; Inflammation; Injury analysis; Ischemia; Laboratory animals; Lung - physiopathology; Lung diseases; Lung Injury - metabolism; Lung Injury - physiopathology; Lungs; Medicine; Medicine and Health Sciences; Neonates; Neutrophils; Newborn babies; Occludin - metabolism; Pediatrics; Permeability; Peroxidase; Peroxidase - analysis; Physical Sciences; Plastic surgery; Proteins; Pulmonary Surfactant-Associated Protein D - analysis; Respiratory distress syndrome; Resuscitation; Risk factors; Shock, Hemorrhagic - immunology; Shock, Hemorrhagic - metabolism; Sodium chloride; Surface active agents; Surfactants; Swine; Tight junctions; Tight Junctions - metabolism; Tissues; Transfusion; Trauma; Tumor necrosis factor-TNF; Ventilators; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0219211

Asphyxia of newborns is a severe and frequent challenge of the peri- and postnatal period. The purpose of this study was to study early morphological, immunological and structural alterations in lung tissue after asphyxia and hemorrhage (AH). 44 neonatal piglets (age 32 hrs) underwent asphyxia and hemorrhage (AH) and were treated according to the international liaison committee of resuscitation (ILCOR) guidelines. For this study, 15 piglets (blood transfusion (RBC) n = 9; NaCl n = 6, mean age 31 hrs) were randomly picked. 4 hours after ROSC (return of spontaneous circulation), lung tissue and blood samples were collected. An elevation of myeloperoxidase (MPO) activity was observed 4 hrs after AH accompanied by an increase of surfactant D after RBC treatment. After AH tight junction proteins Claudin 18 and junctional adhesion molecule 1 (JAM1) were down-regulated, whereas Occludin was increased. Furthermore, after AH and RBC treatment dephosphorylated active form of Connexin 43 was increased. AH in neonatal pigs is associated with early lung injury, inflammation and alterations of tight junctions (Claudin, Occludin, JAM-1) and gap junctions (Connexin 43) in lung tissue, which contributes to the development of lung edema and impaired function.