OBJECTIVEResolution of alveolar damage after lung injury requires finely orchestrated processes that include coordinated and effective tissue reconstruction to reestablish a functional barrier. Reconstitution of denuded type I alveolar epithelial cell that undergo apoptotic and necrotic death after lung injury is required in many pulmonary diseases. Disruption of distal airway development and type II-type I alveolar epithelial cell differentiation after lung injury and disordered repair of the alveolus after injury is one of the predominant pathological characteristics of chronic lung disease (CLD) of premature infants. HoxB5 belongs to the Hox gene family encoding transcription factors known for their role in skeletal patterning and the elaboration of organs. HoxB5 is required for embryonic respiratory tract morphogenesis. The present study aimed to test the hypothesis that HoxB5 may participate in the etiology of CLD and to understand possible mechanism.

METHODSPremature rat pups were taken out surgically at gestational age 21 d. CLD was induced by hyperoxia exposure in neonatal premature rats. Eighty premature rats were randomly exposed to hyperoxia (FiO2 = 0.90, CLD group) and to room air (FiO2 = 0.21, control group) (n = 40 each). Lung specimens were obtained respectively on days 1, 3, 7, 14 and 21 after exposure. Histopathologic changes was assayed after hematoxylin and eosin (HE) staining and pulmonary development was evaluated by lung coefficient and radical alveolar counts (RAC), dynamic changes of RAC were observed; and the expression of HoxB5, AQP-5, and SP-B mRNA were assayed by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThere were no significant differences in the RAC and the expression level of HoxB5, AQP-5, and SP-B mRNA between the CLD and the control groups within 3 days after birth (P > 0.05). However, compared to the control group, the RAC of the CLD group was reduced (6.35 +/- 0.83 vs. 7.67 +/- 0.52), and the expression of HoxB5 (0.98 +/- 0.14 vs. 1.20 +/- 0.16), AQP-5 (0.78 +/- 0.11 vs. 1.04 +/- 0.19) mRNA were significantly lower (P < 0.05), while the expression of SP-B mRNA was increased on the 7th day (P < 0.05). On the 14th day, the RAC and the expression of HoxB5, AQP-5 mRNA of CLD group were significantly lower than those of the control group (P < 0.05), and the expression of SP-B mRNA continued to increase (P < 0.05). On the 21st day, the expression of HoxB5, AQP-5 mRNA decreased to the nadir (0.64 +/- 0.11 vs. 1.18 +/- 0.13 and 0.67 +/- 0.12 vs. 0.97 +/- 0.01, respectively) (P < 0.01), on the same day the expression of SP-B mRNA reached to the pinnacle (1.43 +/- 0.07 vs. 1.12 +/- 0.09) (P < 0.01). The expression of HoxB5 mRNA was positively correlated with RAC in the CLD group (r = 0.685, P < 0.01).

CONCLUSIONSWith hyperoxia exposure, the mRNA expression of specific marker of type I alveolar epithelial cell, AQP-5, was decreased while specific marker of type II alveolar epithelial cell, SP-B, was increased; and the expression of HoxB5 mRNA in lung tissues kept on decreasing. Decreased expression of HoxB5 may associate with the disruption of type II-I alveolar epithelial cell differentiation and thus may play an important role in inhibition of lung development with CLD. The altered Hox gene expression may predispose lung pathology.