This proposal from the Department of Pediatrics, University of Colorado, seeks 5 year funding to establish a new program which investigates persistent pulmonary hypertension of the newborn (PPHN). PPHN is a relatively frequent (1:500 live births) disease of unknown origin associated with a high morbidity and mortality (25-50%) unless treated for days with invasive, expensive, and somewhat risky extracorporeal membrane oxygenation (ECMO). We propose to investigate initial insults (such as oxidant and hemodynamic stress) and mechanisms through which these insults lead to altered vasoreactivity and vascular remodeling (increased matrix, and vascular cell proliferation), clinical hallmarks of PPHN. Available for study are approximately 80-100 patients per year with established PPHN referred to The Children's Hospital, Denver, and 20 born to a high risk population at the University Hospital, where early detection procedures have been developed. Basic insights into mechanisms operating in PPHN will be from the patients, several animal models of neonatal pulmonary hypertension, and cellular and molecular studies. The data will allow early detection and interventions and better therapies aimed at effective vasodilation and restoration of depleted antioxidant defenses. The program will provide early detection, better treatment, and ultimately, prevention, of PPHN.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Specialized Center (P50)
Project #
5P50HL046481-03
Application #
2222958
Study Section
Special Emphasis Panel (SRC (MA))
Project Start
1991-12-30
Project End
1996-11-30
Budget Start
1993-12-01
Budget End
1994-11-30
Support Year
3
Fiscal Year
1994
Total Cost
Indirect Cost
Name
University of Colorado Denver
Department
Pediatrics
Type
Schools of Medicine
DUNS #
065391526
City
Aurora
State
CO
Country
United States
Zip Code
80045
Ivy, D Dunbar; Lee, Dong-Seok; Rairigh, Robyn L et al. (2004) Endothelin B receptor blockade attenuates pulmonary vasodilation in oxygen-ventilated fetal lambs. Biol Neonate 86:155-9
Grover, Theresa R; Parker, Thomas A; Zenge, Jeanne P et al. (2003) Intrauterine hypertension decreases lung VEGF expression and VEGF inhibition causes pulmonary hypertension in the ovine fetus. Am J Physiol Lung Cell Mol Physiol 284:L508-17
Grover, Theresa R; Zenge, Jeanne P; Parker, Thomas A et al. (2002) Vascular endothelial growth factor causes pulmonary vasodilation through activation of the phosphatidylinositol-3-kinase-nitric oxide pathway in the late-gestation ovine fetus. Pediatr Res 52:907-12
Storme, Laurent; Parker, Thomas A; Kinsella, John P et al. (2002) Chronic hypertension impairs flow-induced vasodilation and augments the myogenic response in fetal lung. Am J Physiol Lung Cell Mol Physiol 282:L56-66
Parker, T A; Afshar, S; Kinsella, J P et al. (2001) Effects of chronic estrogen-receptor blockade on ovine perinatal pulmonary circulation. Am J Physiol Heart Circ Physiol 281:H1005-14
Rairigh, R L; Parker, T A; Ivy, D D et al. (2001) Role of inducible nitric oxide synthase in the pulmonary vascular response to birth-related stimuli in the ovine fetus. Circ Res 88:721-6
Parker, T A; le Cras, T D; Kinsella, J P et al. (2000) Developmental changes in endothelial nitric oxide synthase expression and activity in ovine fetal lung. Am J Physiol Lung Cell Mol Physiol 278:L202-8
Cornfield, D N; Resnik, E R; Herron, J M et al. (2000) Chronic intrauterine pulmonary hypertension decreases calcium-sensitive potassium channel mRNA expression. Am J Physiol Lung Cell Mol Physiol 279:L857-62
Parker, T A; Kinsella, J P; Galan, H L et al. (2000) Prolonged infusions of estradiol dilate the ovine fetal pulmonary circulation. Pediatr Res 47:89-96
Parker, T A; Ivy, D D; Galan, H L et al. (2000) Estradiol improves pulmonary hemodynamics and vascular remodeling in perinatal pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol 278:L374-81

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