Mandell E, Seedorf G, Gien J, Abman SH. Vitamin D treatment improves survival and infant lung structure after intraamniotic endotoxin exposure in rats: potential role for the prevention of bronchopulmonary dysplasia. Am J Physiol Lung Cell Mol Physiol 306: L420 -L428, 2014. First published January 10, 2013 doi:10.1152 doi:10. /ajplung.00344.2013 has anti-inflammatory properties and modulates lung growth, but whether vit D can prevent lung injury after exposure to antenatal inflammation is unknown. We hypothesized that early and sustained vit D treatment could improve survival and preserve lung growth in an experimental model of bronchopulmonary dysplasia induced by antenatal exposure to endotoxin (ETX). Fetal rats (E20) were exposed to ETX (10 g), ETX ϩ Vit D (1 ng/ml), or saline (control) via intra-amniotic (IA) injections and delivered 2 days later. Newborn pups exposed to IA ETX received daily intraperitoneal injections of vit D (1 ng/g) or saline for 14 days. Vit D treatment improved oxygen saturations (78 vs. 87%; P Ͻ 0.001) and postnatal survival (84% vs. 57%; P Ͻ 0.001) after exposure to IA ETX compared with IA ETX alone. Postnatal vit D treatment improved alveolar and vascular growth at 14 days by 45% and 25%, respectively (P Ͻ 0.05). Vit D increased fetal sheep pulmonary artery endothelial cell (PAEC) growth and tube formation by 64% and 44%, respectively (P Ͻ 0.001), and prevented ETXinduced reductions of PAEC growth and tube formation. Vit D directly increased fetal alveolar type II cell (ATIIC) growth by 26% (P Ͻ 0.001) and enhanced ATIIC growth in the presence of ETXinduced growth suppression by 73% (P Ͻ 0.001). We conclude that antenatal vit D therapy improved oxygenation and survival in newborn rat pups and enhanced late lung structure after exposure to IA ETX in vivo, which may partly be due to direct effects on vascular and alveolar growth. bronchopulmonary dysplasia; chronic lung disease; vitamin D; lung development; angiogenesis; chorioamnionitis; prematurity; disease prevention; pulmonary hypertension; persistent pulmonary hypertension of the newborn BRONCHOPULMONARY DYSPLASIA (BPD) is the chronic lung disease of infancy that often complicates the clinical course and outcomes of preterm newborns (24). Infants with severe BPD are at high risk for death, prolonged need for ventilator or oxygen support, pulmonary hypertension, recurrent respiratory infections, abnormal lung function, exercise intolerance, and late neurodevelopmental sequelae (4). BPD is characterized by a disruption of distal lung growth with impaired alveologenesis and angiogenesis, but mechanisms that cause these sustained abnormalities of lung structure are poorly understood (11, 44).Epidemiological and preclinical studies have suggested that chorioamnionitis with antenatal inflammation has been strongly associated with a high risk for the development of BPD after preterm birth (17,21,36,38,41). Although chorioamnionitis has been shown to increase lung inflammation, mechanisms through which early inflammation causes sustai...