Regulation of the pulmonary circulation in the fetus and newborn

During the development of the pulmonary vasculature in the fetus, many structural and functional changes occur to prepare the lung for the transition to air breathing. The development of the pulmonary circulation is genetically controlled by an array of mitogenic factors in a temporo-spatial order....

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Bibliographic Details
Published in:Physiological reviews 2010-10, Vol.90 (4), p.1291-1335
Main Authors: Gao, Yuansheng, Raj, J Usha
Format: Article
Language:English
Subjects:
Blood
Fetus - physiology
Fetuses
Gene Expression Regulation, Developmental - physiology
Humans
Infant, Newborn - physiology
Kinases
Lung - blood supply
Lung - embryology
Lung - growth & development
Lungs
Newborn babies
Nitric oxide
Pulmonary Circulation - physiology
Respiration
Signal transduction
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Summary:During the development of the pulmonary vasculature in the fetus, many structural and functional changes occur to prepare the lung for the transition to air breathing. The development of the pulmonary circulation is genetically controlled by an array of mitogenic factors in a temporo-spatial order. With advancing gestation, pulmonary vessels acquire increased vasoreactivity. The fetal pulmonary vasculature is exposed to a low oxygen tension environment that promotes high intrinsic myogenic tone and high vasocontractility. At birth, a dramatic reduction in pulmonary arterial pressure and resistance occurs with an increase in oxygen tension and blood flow. The striking hemodynamic differences in the pulmonary circulation of the fetus and newborn are regulated by various factors and vasoactive agents. Among them, nitric oxide, endothelin-1, and prostaglandin I(2) are mainly derived from endothelial cells and exert their effects via cGMP, cAMP, and Rho kinase signaling pathways. Alterations in these signaling pathways may lead to vascular remodeling, high vasocontractility, and persistent pulmonary hypertension of the newborn.
ISSN:0031-9333
1522-1210
DOI:10.1152/physrev.00032.2009