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Updated: Aug 19, 2026

Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Congenital diaphragmatic hernia, tracheal occlusion, thyroid transcription factor-1, and fetal pulmonary epithelial
Cheryl J Chapin1, Robert Ertsey, Jyoji Yoshizawa
1Cardiovascular Research Institute, University of California, San Francisco, 94143, USA. cheri@itsa.ucsf.edu
Insights
Congenital diaphragmatic hernia (CDH) causes underdeveloped lungs. Tracheal occlusion (TO) in CDH fetuses improved lung growth but altered surfactant and cell development, suggesting complex effects on lung maturation.
Area of Science:
- Developmental biology
- Pulmonary medicine
- Neonatal research
Background:
- Congenital diaphragmatic hernia (CDH) is a severe birth defect linked to high mortality, primarily from pulmonary hypoplasia and hypertension.
- Experimental tracheal occlusion (TO) in animal models shows potential to improve lung growth and maturation in CDH.
Purpose of the Study:
- To investigate the effects of CDH and TO on fetal rat lung growth and maturation.
- To analyze the impact on distal pulmonary epithelium, including cell differentiation and surfactant production.
Main Methods:
- CDH was induced in fetal rats using nitrofen exposure.
- Tracheal occlusion (TO) was performed on CDH fetuses.
- Lung wet weight, DNA content, and gene/protein expression of surfactant proteins (SP), cell markers (RTI(40), RTII(70)), and TTF-1 were analyzed.
Main Results:
- CDH significantly decreased lung weight and DNA content.
- CDH+TO increased lung weight but showed intermediate DNA content.
- CDH altered expression of SP-C, TTF-1, and RTI(40); CDH+TO partially reversed these changes, improving type I cell markers but decreasing surfactant protein expression.
Conclusions:
- Tracheal occlusion partially reverses CDH-induced pulmonary hypoplasia and restores type I cell differentiation.
- However, CDH+TO adversely affects surfactant protein expression in type II cells.
- These lung development alterations may be mediated by changes in thyroid transcription factor-1 (TTF-1) expression.
Abstract:
Congenital diaphragmatic hernia (CDH) occurs in approximately 1:2,500 human births and has high morbidity and mortality rates, primarily due to pulmonary hypoplasia and pulmonary hypertension. Tracheal occlusion (TO), in experimental animals, distends lungs and increases lung growth and alveolar type I cell maturation but decreases surfactant components and reduces alveolar type II cell density. We examined effects of CDH and CDH+TO on lung growth and maturation in fetal rats. To induce CDH, we administered nitrofen (100 mg) to dams at 9.5 days of gestation. We compared lungs from fetuses with CDH, CDH+TO, and those exposed to nitrofen without CDH. CDH decreased lung wet weight bilaterally (P < 0.0001) and DNA content in lung ipsilateral to CDH (P < 0.05). CDH+TO significantly increased lung wet weights bilaterally; DNA content was intermediate between CDH and NC. To evaluate effects on the distal pulmonary epithelium, we examined surfactant mRNA and protein levels, type I and II cell-specific markers (RTI(40) and RTII(70), respectively), and transcriptional regulator thyroid transcription factor-1 (TTF-1). Decreased lung distension (due to CDH) increased SP-C mRNA and TTF-1 protein expression and reduced RTI(40) (P < 0.05 for all). Increased lung distension (due to CDH+TO) reduced expression of SP mRNAs and pro-SP-C and TTF-1 proteins and enhanced expression of RTI(40) (mRNA and protein; P < 0.05 for all). We conclude that CDH+TO partially reverses effects of CDH; it corrects the pulmonary hypoplasia and restores type I cell differentiation but adversely affects SP expression in type II cells. These effects may be mediated through changes in TTF-1 expression.
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