Prenatal microRNA miR-200b Therapy Improves Nitrofen-induced Pulmonary Hypoplasia Associated With Congenital Diaphragmatic Hernia

Ann Surg. 2019 May;269(5):979-987. doi: 10.1097/SLA.0000000000002595.

Abstract

Objective: We aimed to evaluate the use of miR-200b as a prenatal transplacental therapy in the nitrofen rat model of abnormal lung development and congenital diaphragmatic hernia (CDH).

Background: Pulmonary hypoplasia (PH) and pulmonary hypertension determine mortality and morbidity in CDH babies. There is no safe medical prenatal treatment available. We previously discovered that higher miR-200b is associated with better survival in CDH babies. Here, we investigate the role of miR-200b in the nitrofen rat model of PH and CDH and evaluate its use as an in vivo prenatal therapy.

Methods: We profiled miR-200b expression during nitrofen-induced PH using RT-qPCR and in situ hybridization in the nitrofen rat model of PH and CDH. The effects of nitrofen on downstream miR-200b targets were studied in bronchial lung epithelial cells using a SMAD luciferase assay, Western blotting and Immunohistochemistry. We evaluated miR-200b as a lung growth promoting therapy ex vivo and in vivo using lung explant culture and transplacental prenatal therapy in the nitrofen rat model.

Results: We show that late lung hypoplasia in CDH is associated with (compensatory) upregulation of miR-200b in less hypoplastic lungs. Increasing miR-200b abundance with mimics early after nitrofen treatment decreases SMAD-driven TGF-β signaling and rescues lung hypoplasia both in vitro and in vivo. Also, prenatal miR-200b therapy decreases the observed incidence of CDH.

Conclusions: Our data indicate that miR-200b improves PH and decreases the incidence of CDH. Future studies will further exploit this newly discovered prenatal therapy for lung hypoplasia and CDH.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2,4-Dinitrophenol / administration & dosage
  • Abnormalities, Multiple / genetics
  • Abnormalities, Multiple / therapy*
  • Animals
  • Disease Models, Animal
  • Fetal Therapies / methods*
  • Hernias, Diaphragmatic, Congenital / chemically induced
  • Hernias, Diaphragmatic, Congenital / complications
  • Hernias, Diaphragmatic, Congenital / genetics
  • Hernias, Diaphragmatic, Congenital / therapy*
  • Lung / abnormalities*
  • Lung Diseases / complications
  • Lung Diseases / genetics
  • Lung Diseases / therapy*
  • MicroRNAs / therapeutic use*
  • Rats
  • Rats, Sprague-Dawley

Substances

  • MIRN200 microRNA, human
  • MicroRNAs
  • nitrophen
  • 2,4-Dinitrophenol

Supplementary concepts

  • Lung agenesis