ABSTRACT:Previous studies have shown that chorioamnionitis, with increased IL-6, promotes fetal lung maturation and decreases the incidence of respiratory distress syndrome in premature neonates. However, the expression pattern and the effects of IL-6 on fetal lung growth mechanisms remain unknown. IL-6 expression was assessed by in situ hybridization and by real-time PCR between 14.5 and 21.5 d postconception. Normal and nitrofen-induced hypoplastic lung explants were cultured with increasing IL-6 doses or IL-6 neutralizing antibodies. Branching, cellular proliferation (Ki-67) and MAPK phosphorylation in fetal lung explants were analyzed. Pulmonary primitive epithelium expressed IL-6 constitutively throughout all gestational ages, displaying highest levels during earliest stages. In normal and hypoplastic lung explants, IL-6 neutralizing antibodies significantly reduced, whereas IL-6 supplementation induced a biphasic effect (lower doses increased, while the highest dose did not accomplish additional effect) on branching and cellular proliferation. IL-6 enhanced p38-MAPK phosphorylation without changing MEK1/2 and JNK pathways. The present study suggests a physiological role for IL-6 on pulmonary branching mechanisms most likely involving p38-MAPK intracellular signalling pathway. D uring the last decades, the regulating mechanisms of lung branching have been unraveled. This morphogenic process occurs through fundamental cross-talk interactions between epithelial and mesenchymal tissues via extremely complex processes, involving a multitude of effectors including growth factors, extracellular matrix interactions, and hormones (1). The understanding of these mechanisms has clinical relevance since it can open new perspectives in the treatment of fetal lung hypoplasia as well as modulation of lung repair.IL-6 is a pleiotropic cytokine with important roles on acute inflammatory response, infection, hematopoiesis, regulation of bone absorption, cell growth, differentiation, survival, apoptosis, and proliferation (2-4). Several studies have emphasized the importance of IL-6 signaling in several processes of branching organs such as embryonic submandibular gland development (5,6), mammary gland remodeling (7), benign and malign prostate growth (8,9), and lung maturation (10).In fact, several clinical and animal-based studies suggest that antenatal exposure to inflammatory mediators may improve lung volume and compliance as well as accelerate fetal lung maturation (10). In humans, it was demonstrated that IL-6 elevation in fetuses with chorioamnionitis promoted fetal lung maturation by enhancing surfactant protein A (SP-A) synthesis. In fact, fetal IL-6 is a regulatory cytokine of pulmonary surfactant proteins and plays an important role in lung maturity decreasing the incidence of respiratory distress syndrome in preterm neonates (11). In different animal models such as the rat (12), the rabbit (10), and the sheep (13), it was shown that intra-amniotic injection of endotoxin or continuous administration of IL-6 impro...