Airway Expression of the Epithelial Sodium Channel α-Subunit Correlates With Cortisol in Term Newborns

Janér, Cecilia; Pitkänen, Olli; Helve, Otto; Andersson, Sture

doi:10.1542/peds.2011-0167

Cited by 11 publications

(9 citation statements)

References 49 publications

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“…Even at term, antenatal maternal treatment with betamethasone decreases the incidence of respiratory distress in infants delivered by elective CS [27]. The higher content of liquid by ultrasound at 3 h may reflect lower expression or activity, or both, of ENaC in infants delivered by elective CS [28,29]. …”

Section: Discussionmentioning

confidence: 99%

Delayed Lung Liquid Absorption after Cesarean Section at Term

Martelius¹,

Janér

Süvari

et al. 2013

Neonatology

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Background: Delayed postnatal removal of lung liquid may result in respiratory distress, which is more common in infants born by cesarean section. Vertical artefacts (B-lines) arising from the lung surface in lung ultrasound have been shown to correlate with the liquid content of the lungs. Objectives: We studied whether lung ultrasound could be used for the assessment of postnatal lung liquid in healthy term infants born vaginally and by cesarean section. Methods: Lung ultrasound was performed 1, 3 and 24 h after birth to 22 vaginally born infants and 20 infants born by elective cesarean section. The abundance of B-lines was scored for each infant and time point by two independent observers blinded to the mode of delivery and time point on the examination on a five-step scale. Results: In both groups, a significant decrease in abundance of B-lines, indicative of lung liquid absorption, was observed during the first 24 h. 3 h after birth cesarean section was associated with significantly higher lung liquid content than vaginal delivery. Conclusion: The noninvasive bedside ultrasound method for estimation of lung liquid is a promising tool for the early identification of infants at risk for pulmonary maladaptation.

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Section: Discussionmentioning

confidence: 99%

Delayed Lung Liquid Absorption after Cesarean Section at Term

Martelius¹,

Janér

Süvari

et al. 2013

Neonatology

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“…This association of βENaC expression with cortisol concentrations suggests a role for βENaC in lung liquid clearance during pulmonary adaptation and may offer support to preventive strategies for respiratory distress especially in late preterm and early term infants. As previously shown, βENaC mRNA decreased during the first postnatal day [18,21], underlining its possible role in early pulmonary liquid absorption.…”

Section: Discussionmentioning

confidence: 73%

“…Infants delivered by elective CD at term may, with regard to respiratory morbidity, benefit from antenatal GCs [19]. In term infants, airway epithelial expression of ENaC correlates with cortisol concentrations in cord plasma and saliva [18]. Here, in late preterm and term infants, airway expression of both α- and βENaC correlated with cord cortisol concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Sample preparation and quantitative real-time PCR following the reverse transcription to cDNA were performed as previously [18]. α- and βENaC, and SGK1 TaqMan® assays (Applied Biosystems, Life Technologies Corp., Carlsbad, Calif., USA) were utilized for the singleplex PCR reactions with an ABI Prism 7000 Sequence Detection System (Applied Biosystems).…”

Section: Methodsmentioning

confidence: 99%

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Duration of Gestation and Mode of Delivery Affect the Genes of Transepithelial Sodium Transport in Pulmonary Adaptation

et al. 2014

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Background: Respiratory distress due to inadequate lung liquid clearance is a significant problem in infants delivered late preterm or early term, especially by elective cesarean delivery (CD). Lung liquid clearance depends on epithelial ion transport and in animals is induced by glucocorticoids. Objectives: In newborn late preterm and term infants to study airway epithelial gene expressions of epithelial sodium channel (ENaC), and the serum and glucocorticoid-inducible kinase 1 (SGK1), and their association with cortisol, mode of delivery, and gestational age (GA). Methods: Infants were delivered at 35^0/7-41^6/7 weeks. Cortisol in umbilical cord plasma was analyzed with liquid chromatography-tandem mass spectrometry. ENaC and SGK1 mRNAs in airway epithelial cells obtained within 3 h and at 1 day postnatally were quantified with real-time PCR. Results: ENaC and SGK1 mRNAs were significantly lower in late preterm and early term infants than in those ≥39^0/7 weeks. Significant correlations existed between both ENaC and SGK1 and cord cortisol and GA. In term infants, SGK1 mRNA at 1.5 h was higher after vaginal delivery than elective CD. Conclusions: In late preterm and early term infants, low expression of ENaC and SGK1 may parallel insufficient lung liquid clearance predisposing to respiratory distress. Lower SGK1 expression after term CD could translate into insufficient sodium and lung liquid absorption. The findings demonstrate a central role for cortisol in regulation of ENaC and potentially perinatal sodium and lung liquid clearance.

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“…193,194 Thyroidectomy of fetal sheep completely abolishes the actions of epinephrine on lung liquid absorption, 195 and infusion of T 3 restores responsiveness. 205 Chronic exposure to epinephrine also upregulates Na + -K + -ATPase, 206 though the short-term effects of this agent are on the opening probability of ENaC. However, if both T 3 and hydrocortisone were infused (to produce plasma levels in the upper part of the range seen just before full term), then responsiveness to epinephrine could be induced in younger fetuses (116-120 days) than normal.…”

Section: Humoral Regulationmentioning

confidence: 99%