On the basis of in vivo animal studies and on experiments of nature, it has been suggested that fetal breathing movements are essential for normal lung growth in utero. To study this hypothesis in vitro, we examined the effect of mechanical stretch on proliferation of fetal rat lung cells maintained in organotypic culture to provide a three-dimensional matrix. Initial studies demonstrated that stretch-mediated effects on cell division and DNA synthesis in such cultures were influenced by cell inoculation density, fetal calf serum concentration, and by the amplitude, frequency, periodicity, and duration of the applied stretch. After a 48-h exposure to an intermittent stretch pattern (5% elongation, 60 stretches/min for 15 min of each hour), cell number increased 10% (P less than 0.05), cell doubling time was reduced from 71 to 55 h (P less than 0.05), [3H]thymidine incorporation into DNA increased 61% (P less than 0.01), and the [3H]thymidine-labeling index increased 2.8-fold (P less than 0.001) compared with nonstretched controls. This effect did not appear to be mediated by prostaglandins or leukotrienes because the prostaglandin synthase inhibitors ibuprofen (2.5-50 microM) or BW 755C (5 microM), leukotriene biosynthesis inhibitors BW 755C (5 microM) or MK-886 (0.3 microM), and leukotriene D4 receptor antagonist MK-571 (0.3 microM) did not block stretch-mediated effects. We conclude that mechanical forces act directly to stimulate fetal rat lung cell growth and that these results are compatible with a significant role for fetal breathing in normal fetal lung growth.(ABSTRACT TRUNCATED AT 250 WORDS)

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These results support a critical role for the Ang-1/Tie2 axis in modulating the pulmonary vascular response to lung injury and suggest that Ang-1 therapy may represent a potential new strategy for the treatment and/or prevention of acute respiratory distress syndrome in critically ill patients.