周産期異常と関連する児の肺血管病変

抄録

Pediatric pulmonary vascular disease such as pulmonary occlusive vasculopathy and pulmonary hypertension is associated with various perinatal insults, including fetal growth restriction and hypoxic-ischemic injury. However, the underlying mechanisms remain to be fully elucidated. In this symposium, I would like to introduce two studies related to the topic. One is a preclinical study demonstrating that perinatal hypoxia aggravates occlusive pulmonary vasculopathy in the offspring treated with hypoxia and SU5416 later in life. The global changes of DNA methylation in the smooth muscle cells caused by perinatal hypoxia may be associated with the phenotype. The other is a set of clinical studies showing that treatment of fetal growth restriction by sildenafil may increase the incidence of pulmonary hypertension in the newborn. Rebound vasoconstriction after cessation of sildenafil may be related to the pathophysiological mechanism. I would like to discuss how perinatal insults could affect pediatric pulmonary vasculature, considering the epigenetic change caused by hypoxia and the difference between PDE5 inhibitors.