Placental pathologic changes of maternal vascular underperfusion in bronchopulmonary dysplasia and pulmonary hypertension.

INTRODUCTION: Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease of infancy, and BPD-associated pulmonary hypertension (PH) is a serious complication that can negatively impact later childhood health. There is growing evidence that lung injury leading to BPD and PH is due to chronic fetal hypoxia-ischemia. The purpose of this study was to investigate whether placental pathologic changes of maternal vascular underperfusion (MVU) are associated with BPD, and further increased with PH. METHODS: We conducted a 5-year retrospective cohort study of premature infants born ≤28 weeks. BPD was defined as persistent oxygen requirement at 36 weeks corrected gestational age. PH was identified using a standardized algorithm of echocardiogram review. Archived placental slides underwent standardized masked histopathologic review. Logistic regression modeling was performed, taking into account important maternal and infant covariates. RESULTS: Among 283 births, 121 had MVU, of which 67 (55%) developed BPD, and 24 (20%) had PH. Among the common neonatal complications of extreme prematurity, BPD was the only outcome that was increased with MVU (P < 0.001). After adjustment for birth weight, fetal growth restriction, preeclampsia and other factors, infants with MVU were more likely to develop BPD (adjusted odds ratio = 2.6; 95% confidence interval = 1.4, 4.8). Certain MVU sublesions (fibrinoid necrosis/acute atherosis and distal villous hypoplasia/small terminal villi) were increased with PH (P < 0.001). DISCUSSION: Placental MVU may identify BPD infants who were exposed to intrauterine hypoxia-ischemia, which increases their risk for development of PH disease. CONCLUSIONS: Our findings have important implications for providing earlier and more effective therapies for BPD.

Transforming growth factor-beta1 inhibits rat prolactin promoter activity in GH4 neuroendocrine cells.

The prototypic member of the transforming growth factor beta family is TGFbeta1, which is known to be important in extracellular matrix production, cell proliferation, and cell differentiation. Specifically in the pituitary lactotroph, TGFbeta1 inhibits prolactin (PRL) peptide secretion, PRL mRNA levels, and PRL gene transcription. To further elucidate the molecular details by which TGFbeta1 modulates PRL gene transcription, we used a transient transfection approach to characterize and to map the TGFbeta1 inhibitory response element of the rat (r) PRL promoter. Here, we show that TGFbeta1 selectively inhibits basal rPRL promoter activity in GH4 cells in a dose-responsive fashion, with an IC50 of 6 pM, and that this inhibition occurs within 6 h after TGFbeta1 addition. Using a series of 5' deletion promoter mutants, the TGFbeta1 inhibitory response was found to be unaffected by deletion to position -116 and was abrogated by further deletion to -54 in the rPRL promoter. However, on the basis of data from site-specific and linker-scanning mutants of the rPRL promoter, it appears that no single element is sufficient to mediate the TGFbeta1 inhibitory effect. Sequence analysis of the -116/-54 region failed to reveal any sequence homology to previously characterized TGFbeta response elements. Finally, TGFbeta1 failed to alter significantly the endogenous levels of the cell-specific activator protein GHF-1/Pit-1, indicating that the TGFbeta1 inhibitory effect is not attributable to diminished levels of GHF-1/Pit-1. Taken together, these data indicate that the TGFbeta1 inhibitory response is more complex than previously appreciated, requiring more than one cis-acting element and not always acting via TTGG or GTCTAGAC sites.

The c-Jun delta-domain inhibits neuroendocrine promoter activity in a DNA sequence- and pituitary-specific manner.

The transcription and transformation activity of c-Jun is governed by a 27-amino acid regulatory motif, labeled the delta-domain, which is deleted in v-Jun. We have previously shown that c-Jun is a potent inhibitor of the rat prolactin (rPRL) promoter activity induced by either oncogenic Ras or phorbol esters. Here, we have characterized the structural and cell-specific requirements for this c-Jun inhibitory response, and we show that this c-Jun inhibitory response mapped to the rPRL footprint II repressor site, was pituitary-specific and required the c-Jun delta-domain. Moreover, alteration of any one of these features (e.g., cis-element, trans-factor, or cell-specific background) switched c-Jun to a transcriptional activator of the rPRL promoter. In HeLa nonpituitary cells, c-Jun alone activated the rPRL promoter via the most proximal GHF-1/Pit-1 binding site, footprint I, and synergized with GHF-1. Finally, recombinant GHF-1 interacted directly with c-Jun but not c-Fos proteins. These data provide important fundamental insights into the molecular mechanisms by which the c-Jun delta-domain functions as a modulatory switch and further imply that the functional role of c-Jun is dictated by cell-specific influences and the delta-domain motif.