| Objective: To evaluate the effect of budesonide combined with Poractant Alfa on preventing the effect of bronchial pulmonary dysplasia,and further to explore whether SIRT1 signaling pathway mediated in the role of budesonide combined with Poractant Alfa on preventing of bronchopulmonary dysplasia by detecting of the content of ROS,SENP1,SIRT1 and the nucleocytoplasmic shuttling situation of SIRT1.Methods: One hundred and twenty preterm infants 6 hours after birth(gestational age≤32weeks and birth weights≤1 500 g)admitted to Department of Newborn Medicine,the Affiliated Hospital,Southwest Medical University from October2013 to February 2015 were randomly divided into 4 groups(30 cases in each group).Group A was control group;group B was neonatal respiratory distress syndrom(NRDS);group C was NRDS with surfactant group;group D was NRDS with surfactant and budesonide group.Thirty-two weeks following unless the other diseases and without oxygen in preterm infants within 48 h as group A.Group B were treated by continuous uptaking oxygen with continuous positive airway pressure(CPAP)(Oxygen lasts more than 48 h and oxygen concentrations more than 40%).Group C were treated with 100mg/Kg pulmonary surfactants(PS)within 48 h on the basis of group B.Group D were treated with 0.25mg/Kg budesonide suspension for inhalation on the basis ofgroup C.The PH value,partial pressure of oxyge(PO2),partial pressure of carbon dioxide(PCO2)in blood gas analysis were all detected in every groups before and 1,6,12,24 and 48 hours after using drug.Above all groups were also observed whether to have a respirator assisted ventilation,the high oxygen using duration;the total oxygen time,the rate of using PS again,the rate of BPD,the total hospitalization days and the adverse effects.The adverse effects included high blood pressure,high blood sugar,necrotizing enterocolitis(NEC)and the incidence of nosocomial infection.In addition,48 h after birth about control group,and oxygen inhalation for 48 h about the rest of the three groups,the peripheral blood of these infants were collected and isolated mononuclear cells.The levels of ROS in PBMCs were detected by Laser confocal.SIRT1 in PBMCs were detected by positioning immunofluorescence technology.The expression levels of SIRT1 and SENP1 in PBMCs were detected by blot Western.Results: Compared with the group B,the PH value at 1 and 6 hours after using drugs,the PO2 and PCO2 at 1,6 and 12 hours after using drugs were improved obviously in the group C and D.The differences were statistically significant(all P<0.01).Moreover,Compared with the group B,the oxygen inhalation duration,the rate of having a respirator assisted ventilation and using PS again,and the incidence of BPD were obviously decreased in other groups.The differences were statistically significant(all P<0.05).The incidence of BPD in the group D was less than the group C,the differences were statistically significant(X2=4.00,P<0.05).The total oxygen time and the rate of untowardeffects of each groups were similar.The differences were not statistically significant(P>0.05).Compared with the control group,the ROS level of NRDS group was significantly increased,the expression of SENP1 increased,the rate of nuclear cytoplasm shuttle increased,and the expression of SIRT1 in nucleus decreased.Compared with NRDS group,when treated with budesonide and poractant Alfa,ROS levels decreasd,SENP1 expression decreased,SIRT1 nuclear pulp shuttling rate reduced,nuclear SIRT1 expression increased.The differences were statistically significant(all P<0.01).Conclusion: Budesonide combined wih Poractant Alfa can prevent BPD in preterm infants.Its effect is better than the simple use of Poractant Alfa,and the rate of adverse effects are not increased significantly.Furthermore,SIRT1 signal pathway mediated in the role of Budesonide combined with Poractant Alfa on preventing of BPD.It showed that SENP1 expression decreased,SIRT1 nuclear plasma shuttle rate decreased,the expression of SIRT1 in the nucleus increased. |
PDF Full Text Request