Neuropathology as a consequence of neonatal ventilation in premature growth-restricted lambs

Atul Malhotra, Margie Castillo-Melendez, Beth J. Allison, Amy E. Sutherland, Ilias Nitsos, Yen Pham, Anna K. Alves de Alencar Rocha, Michael C. Fahey, Graeme R. Polglase, Graham Jenkin, Suzanne L. Miller

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Fetal growth restriction (FGR) and prematurity are associated with high risk of brain injury and long-term neurological deficits. FGR infants born preterm are commonly exposed to mechanical ventilation, but it is not known whether ventilation differentially induces brain pathology in FGR infants compared with appropriate for gestational age (AGA) infants. We investigated markers of neuropathology in moderate-to late-preterm FGR lambs, compared with AGA lambs, delivered by caesarean birth and ventilated under standard neonatal conditions for 24 h. FGR was induced by single umbilical artery ligation in fetal sheep at 88-day gestation (term, 150 days). At 125-day gestation, FGR and AGA lambs were delivered, dried, intubated, and commenced on noninjurious ventilation, with surfactant administration at 10 min. A group of unventilated FGR and AGA lambs at the same gestation was also examined. Over 24 h, circulating pH, PO2, and lactate levels were similar between groups. Ventilated FGR lambs had lower cerebral blood flow compared with AGA lambs (P = 0.01). The brain of ventilated FGR lambs showed neuropathology compared with unventilated FGR, and unventilated and ventilated AGA lambs, with increased apoptosis (caspase-3), blood-brain barrier dysfunction (albumin extravasation), activated microglia (Iba-1), and increased expression of cellular oxidative stress (4-hydroxynonenal). The neuropathologies seen in the ventilated FGR brain were most pronounced in the periventricular and subcortical white matter but also evident in the subventricular zone, cortical gray matter, and hippocampus. Ventilation of preterm FGR lambs increased brain injury compared with AGA preterm lambs and unventilated FGR lambs, mediated via increased vascular permeability, neuroinflammation and oxidative stress.

Original languageEnglish
Pages (from-to)R1183-R1194
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume315
Issue number6
DOIs
Publication statusPublished - 1 Dec 2018

Keywords

  • Blood-brain barrier
  • FGR
  • IUGR
  • Neuroinflammation
  • Oxidative stress

Cite this

@article{97eb69acf6f843b4a0b1237d311df288,
title = "Neuropathology as a consequence of neonatal ventilation in premature growth-restricted lambs",
abstract = "Fetal growth restriction (FGR) and prematurity are associated with high risk of brain injury and long-term neurological deficits. FGR infants born preterm are commonly exposed to mechanical ventilation, but it is not known whether ventilation differentially induces brain pathology in FGR infants compared with appropriate for gestational age (AGA) infants. We investigated markers of neuropathology in moderate-to late-preterm FGR lambs, compared with AGA lambs, delivered by caesarean birth and ventilated under standard neonatal conditions for 24 h. FGR was induced by single umbilical artery ligation in fetal sheep at 88-day gestation (term, 150 days). At 125-day gestation, FGR and AGA lambs were delivered, dried, intubated, and commenced on noninjurious ventilation, with surfactant administration at 10 min. A group of unventilated FGR and AGA lambs at the same gestation was also examined. Over 24 h, circulating pH, PO2, and lactate levels were similar between groups. Ventilated FGR lambs had lower cerebral blood flow compared with AGA lambs (P = 0.01). The brain of ventilated FGR lambs showed neuropathology compared with unventilated FGR, and unventilated and ventilated AGA lambs, with increased apoptosis (caspase-3), blood-brain barrier dysfunction (albumin extravasation), activated microglia (Iba-1), and increased expression of cellular oxidative stress (4-hydroxynonenal). The neuropathologies seen in the ventilated FGR brain were most pronounced in the periventricular and subcortical white matter but also evident in the subventricular zone, cortical gray matter, and hippocampus. Ventilation of preterm FGR lambs increased brain injury compared with AGA preterm lambs and unventilated FGR lambs, mediated via increased vascular permeability, neuroinflammation and oxidative stress.",
keywords = "Blood-brain barrier, FGR, IUGR, Neuroinflammation, Oxidative stress",
author = "Atul Malhotra and Margie Castillo-Melendez and Allison, {Beth J.} and Sutherland, {Amy E.} and Ilias Nitsos and Yen Pham and {Alves de Alencar Rocha}, {Anna K.} and Fahey, {Michael C.} and Polglase, {Graeme R.} and Graham Jenkin and Miller, {Suzanne L.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1152/ajpregu.00171.2018",
language = "English",
volume = "315",
pages = "R1183--R1194",
journal = "American Journal of Physiology - Regulatory Integrative and Comparative Physiology",
issn = "1522-1490",
publisher = "American Physiological Society",
number = "6",

}

Neuropathology as a consequence of neonatal ventilation in premature growth-restricted lambs. / Malhotra, Atul; Castillo-Melendez, Margie; Allison, Beth J.; Sutherland, Amy E.; Nitsos, Ilias; Pham, Yen; Alves de Alencar Rocha, Anna K.; Fahey, Michael C.; Polglase, Graeme R.; Jenkin, Graham; Miller, Suzanne L.

In: American Journal of Physiology - Regulatory Integrative and Comparative Physiology, Vol. 315, No. 6, 01.12.2018, p. R1183-R1194.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Neuropathology as a consequence of neonatal ventilation in premature growth-restricted lambs

AU - Malhotra, Atul

AU - Castillo-Melendez, Margie

AU - Allison, Beth J.

AU - Sutherland, Amy E.

AU - Nitsos, Ilias

AU - Pham, Yen

AU - Alves de Alencar Rocha, Anna K.

AU - Fahey, Michael C.

AU - Polglase, Graeme R.

AU - Jenkin, Graham

AU - Miller, Suzanne L.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Fetal growth restriction (FGR) and prematurity are associated with high risk of brain injury and long-term neurological deficits. FGR infants born preterm are commonly exposed to mechanical ventilation, but it is not known whether ventilation differentially induces brain pathology in FGR infants compared with appropriate for gestational age (AGA) infants. We investigated markers of neuropathology in moderate-to late-preterm FGR lambs, compared with AGA lambs, delivered by caesarean birth and ventilated under standard neonatal conditions for 24 h. FGR was induced by single umbilical artery ligation in fetal sheep at 88-day gestation (term, 150 days). At 125-day gestation, FGR and AGA lambs were delivered, dried, intubated, and commenced on noninjurious ventilation, with surfactant administration at 10 min. A group of unventilated FGR and AGA lambs at the same gestation was also examined. Over 24 h, circulating pH, PO2, and lactate levels were similar between groups. Ventilated FGR lambs had lower cerebral blood flow compared with AGA lambs (P = 0.01). The brain of ventilated FGR lambs showed neuropathology compared with unventilated FGR, and unventilated and ventilated AGA lambs, with increased apoptosis (caspase-3), blood-brain barrier dysfunction (albumin extravasation), activated microglia (Iba-1), and increased expression of cellular oxidative stress (4-hydroxynonenal). The neuropathologies seen in the ventilated FGR brain were most pronounced in the periventricular and subcortical white matter but also evident in the subventricular zone, cortical gray matter, and hippocampus. Ventilation of preterm FGR lambs increased brain injury compared with AGA preterm lambs and unventilated FGR lambs, mediated via increased vascular permeability, neuroinflammation and oxidative stress.

AB - Fetal growth restriction (FGR) and prematurity are associated with high risk of brain injury and long-term neurological deficits. FGR infants born preterm are commonly exposed to mechanical ventilation, but it is not known whether ventilation differentially induces brain pathology in FGR infants compared with appropriate for gestational age (AGA) infants. We investigated markers of neuropathology in moderate-to late-preterm FGR lambs, compared with AGA lambs, delivered by caesarean birth and ventilated under standard neonatal conditions for 24 h. FGR was induced by single umbilical artery ligation in fetal sheep at 88-day gestation (term, 150 days). At 125-day gestation, FGR and AGA lambs were delivered, dried, intubated, and commenced on noninjurious ventilation, with surfactant administration at 10 min. A group of unventilated FGR and AGA lambs at the same gestation was also examined. Over 24 h, circulating pH, PO2, and lactate levels were similar between groups. Ventilated FGR lambs had lower cerebral blood flow compared with AGA lambs (P = 0.01). The brain of ventilated FGR lambs showed neuropathology compared with unventilated FGR, and unventilated and ventilated AGA lambs, with increased apoptosis (caspase-3), blood-brain barrier dysfunction (albumin extravasation), activated microglia (Iba-1), and increased expression of cellular oxidative stress (4-hydroxynonenal). The neuropathologies seen in the ventilated FGR brain were most pronounced in the periventricular and subcortical white matter but also evident in the subventricular zone, cortical gray matter, and hippocampus. Ventilation of preterm FGR lambs increased brain injury compared with AGA preterm lambs and unventilated FGR lambs, mediated via increased vascular permeability, neuroinflammation and oxidative stress.

KW - Blood-brain barrier

KW - FGR

KW - IUGR

KW - Neuroinflammation

KW - Oxidative stress

UR - http://www.scopus.com/inward/record.url?scp=85058815125&partnerID=8YFLogxK

U2 - 10.1152/ajpregu.00171.2018

DO - 10.1152/ajpregu.00171.2018

M3 - Article

VL - 315

SP - R1183-R1194

JO - American Journal of Physiology - Regulatory Integrative and Comparative Physiology

JF - American Journal of Physiology - Regulatory Integrative and Comparative Physiology

SN - 1522-1490

IS - 6

ER -