실험쥐의 선천성 횡격막 헤르니아와 폐 형성 저하증에 대한 비타민 A 투여 효과
Vitamin A Effect to Nitrofen Induced Congenital Diaphragmatic Hernia and Pulmonary Hypoplasia in Rats
이환봉, 김인구, 이병찬,
소속 상세정보
이환봉 ( Lee Hwan-Bong )
원광대학교 의과대학 외과학교실
김인구 ( Kim In-Koo )
울산대학교 의과대학 외과학교실
이병찬 ( Lee Pyung-Chan )
울산대학교 의과대학 외과학교실
KMID : 0371320040660020089
Abstract
Purpose: Vitamin A has been introduced recently for its feasible effect in curing diaphragmatic defect and accelerating lung development during the perinatal period of experimental rats or humans suffering from congenital diaphragmatic hernia (CDH). Despite continual research attention since the fifties to elucioate the influence and mechanisms of vitamin A on pulmonary growth, many presumptive hypotheses remain, along with an inherently high mortality. So we wondered whether prenatal vitamin A alone or combined with dexamethasone could accomplish better results than dexamethasone against the diaphragmatic defect or lung hypoplasia in neonatal rats.
Methods: Pregnant Sprague-Dawley rats exposed to Nitrofen were classified into 5 groups according to the different treatment options. Studies were performd in 2 phases. In study 1, the 24-hour survival rate and preliminary results were observed. In study 2, the incidence and site of CDH, lung/body weight ratio (L/BWR), radial saccular counts (RSC) and maturation of alveolar sac in 3 histomorphologic grades were evaluated among the 5 groups.
Results: Vitamin A treated neonatal rats (group Ⅲ) showed improved lung development compared with rats without treatments (group Ⅱ) in 24-hour survival rate, L/BWR and alveolar matulation (P<0.001), leading to lung development that was comparable in every aspect to that of the dexamethasole treated rats (group Ⅳ). Combined treatment by vitamin A and dexamethasone (group Ⅴ) improved the incidence of CDH, L/BWR (P<0.001), RSC (P<0.05) and alveolar maturation (P<0.001) when compared with rats treated alone by vitamin A (group Ⅲ) or dexamethasone (group Ⅳ), leading to a level of development that was closest to that of the normal control lungs (group Ⅰ). Conclusion: Vitamin A had a therapeutic effect on pulmonary hypoplasia in the experimental rats, and when combined with dexamethasone it accomplished a better outcome in the treatment of CDH itself or pulmonary hypoplasia. After the problem of vitamin A toxicity is settled, the future of vitamin A as a prenatal therapeutic agent for CDH might gain in appeal.
키워드
나이트로펜;선천성 횡경막 헤르니아;비타민 A;덱사메티손;폐형성저하증;Nitrofen;Congenital diaphragmatic hernia;Vitamin A;Dexamethasone pulmonary hypoplasia
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