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Airway muscle in preterm infants: changes during development
S L Sward-Comunelli1, S M Mabry, W E Truog
1Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, USA.
The Journal of Pediatrics
|April 1, 1997
Summary
Airway smooth muscle is present in premature infants from 23 weeks gestation. Infants with chronic lung disease (CLD) show increased airway muscle, suggesting bronchospasm is possible in very low birth weight infants.
Area of Science:
- Neonatal physiology
- Pulmonary development
- Pediatric pathology
Background:
- Airway smooth muscle plays a critical role in respiratory function.
- Understanding airway muscle development is crucial for managing neonatal respiratory conditions.
- Chronic lung disease (CLD) in infants can lead to significant airway abnormalities.
Purpose of the Study:
- To quantify airway muscle development in infants across a range of gestational ages.
- To compare airway muscle in healthy infants with those suffering from CLD.
- To investigate the potential for bronchospasm in premature infants.
Main Methods:
- Studied 55 human lungs from infants (23-41 weeks gestation), including 9 with CLD.
- Utilized immunohistochemistry for alpha-smooth muscle actin staining.
- Employed computerized image analysis to measure airway muscle, epithelium, and lumen size.
Main Results:
- Airway muscle is present from 23 weeks gestation in all airway levels.
- Control lungs showed consistent muscle quantity relative to airway circumference from 25 weeks gestation.
- Infants with CLD exhibited significantly more airway muscle in larger airways (>1500 microns circumference).
Conclusions:
- Airway muscle development is established early in gestation.
- Preterm infants with CLD demonstrate increased airway muscle, particularly in larger airways.
- The findings suggest the potential for bronchospasm in very low birth weight infants shortly after birth.