Bile Acid-Induced Lung Injury in Newborn Infants: A Bronchoalveolar Lavage Fluid Study

Zecca, Enrico; Luca, Danièle De; Baroni, Silvia; Vento, Giovanni; Tiberi, Eloisa; Romagnoli, Costantino

doi:10.1542/peds.2007-1220

Cited by 74 publications

(57 citation statements)

References 22 publications

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“…This suggests that, in addition to Foxm1b, FXR may regulate expression of other genes during acute lung repair. We should also note that FXRϪ/Ϫ mice have increased bile acid levels that may be related to certain lung injury (30). Therefore, whether FXR in other organs besides lung also involve in the LPS-induced lung injury needs more investigation.…”

Section: Discussionmentioning

confidence: 98%

FXR Protects Lung from Lipopolysaccharide-Induced Acute Injury

Zhang

et al. 2012

Molecular Endocrinology

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Acute lung injury and its more severe form, acute respiratory distress syndrome, are characterized by an acute inflammatory response in the airspaces and lung parenchyma. The nuclear receptor farnesoid X receptor (FXR) is expressed in pulmonary artery endothelial cells. Here, we report a protective role of FXR in a lipopolysaccharide-induced mouse model of acute lung injury. Upon intratracheal injection of lipopolysaccharide, FXR-/- mice showed higher lung endothelial permeability, released more bronchoalveolar lavage cells to the alveoli, and developed acute pneumonia. Cell adhesion molecules were expressed at higher levels in FXR-/- mice as compared with control mice. Furthermore, lung regeneration was much slower in FXR-/- mice. In vitro experiments showed that FXR activation blocked TNFα-induced expression of P-selectin but stimulated proliferation of lung microvascular endothelial cells through up-regulation of Foxm1b. In addition, expression of a constitutively active FXR repressed the expression of proinflammatory genes and improved lung permeability and lung regeneration in FXR-/- mice. This study demonstrates a critical role of FXR in suppressing the inflammatory response in lung and promoting lung repair after injury.

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Section: Discussionmentioning

confidence: 98%

FXR Protects Lung from Lipopolysaccharide-Induced Acute Injury

Zhang

et al. 2012

Molecular Endocrinology

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“…Previous studies have showed that high concentration of bile acid gathered in alveolus cleaning solution in ICP neonates [22], but the incidence of ICP in neonatus had no direct correlation with bile acid concentration in amniotic fluid, while it had close relationship with high bile acid level in fetal blood [2, 23]. Our results demonstrate that (1) bile acid concentration of fetal rats serum in dose group was significantly higher than that of the experimental group and blank control group, and there is positive correlation between TBA of pregnant rat serum and that of fetal rat serum; (2) the still birth rate in dose groups was significantly higher than that of the experimental group and blank control group.…”

Section: Discussionmentioning

confidence: 99%

Effect of Bile Acid on Fetal Lung in Rat Model of Intrahepatic Cholestasis of Pregnancy

Ding

Huang

et al. 2014

International Journal of Endocrinology

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Objective. To determine the correlation between maternal bile acid (BA) level and fetal pulmonary surfactant in rats and study the effects of BA on fetal lung in rat model of intrahepatic cholestasis of pregnancy. Methods. Forty pregnant rats were treated with (A) 5.5 mg/kg BA, (B) 1.4 mg/kg BA, and (C) 1 ml physiological saline. Levels of total bile acid (TBA), ALT, AST, TBIL, DBIL, and SP-A were determined and the lungs of fetal rats were analyzed for pathological changes. Results. Groups A and B intervened with BA showed significant higher level of TBA in both maternal and fetal serum, more mortality rate of fetal rats, more concentration of SP-A in fetal serum, and wider alveolus mesenchyme of fetal rats than the control Group C. Higher level of BA associated with increased fetal risk and lower numerical density of mitochondria in type II alveolar epithelial cells. The levels of TBA in maternal serum were found to have significant positive correlation with those in fetal serum and SP-A level but negatively with the area of alveolus and the numerical density of lamellar body. Conclusions. The TBA level in maternal serum showed significant association with lung pathological changes in fetal rats.

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“…There is understandably a paucity of studies done on humans but experimental studies conducted on rats [10], rabbits [11] and pigs [12], have demonstrated that bile acids cause inflammation and cytotoxic effects on histologic examinations. Similarly, broncho-alveolar lavage studies have found a positive correlation between increased bile acid levels and inflammatory markers in blood, increased neutrophilia [13], inflammation in alveoli and ventilator associated pneumonias [9]. Likewise visceral inflammation and injury of lungs, larynxes were found to be related to Bile Juice reflux independently of acid reflux in gastroesophageal reflux diseases [6].…”

Section: Discussionmentioning

confidence: 95%

Anesthesia Fatality due to Bile Aspiration: Lessons to be Learnt

Alvi¹

2016

General Anesthesia and Sleep

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Anesthetic related fatality is rare in this time and age in young patients who are ASA II (American Society of Anesthesiologists). Our patient had a very unfortunate anesthetic mortality due to aspiration of bilious vomit. A posthumous diagnosis of post Endoscopic Retrograde Cholangio-pancreatography (ERCP) pancreatitis leading to ileus was missed before surgery. There is a brief literature search about perils of bile aspiration, post ERCP pancreatitis and why pancreatitis is a lethal combination with acute respiratory distress syndrome (ARDS).

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Bile Acid-Induced Lung Injury in Newborn Infants: A Bronchoalveolar Lavage Fluid Study

Cited by 74 publications

References 22 publications

FXR Protects Lung from Lipopolysaccharide-Induced Acute Injury

FXR Protects Lung from Lipopolysaccharide-Induced Acute Injury

Effect of Bile Acid on Fetal Lung in Rat Model of Intrahepatic Cholestasis of Pregnancy

Anesthesia Fatality due to Bile Aspiration: Lessons to be Learnt

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