Mechanisms of Inflammatory Lung Injury in the Neonate: Lessons from a Transgenic Mouse Model of Bronchopulmonary Dysplasia

The role of inflammation in the pathogenesis of bronchopulmonary dysplasia (BPD) is not well understood. By using a transgenic mouse expressing the inflammatory cytokine interleukin (IL)-1 beta in the lung, we have shown that perinatal expression of IL-1 beta causes a BPD-like illness in infant mice. We have used this model to identify mechanisms by which inflammation causes neonatal lung injury. Increased matrix metalloproteinase (MMP)-9 activity is associated with BPD. MMP-9 deficiency worsens alveolar hypoplasia in IL- 1 beta-expressing newborn mice, suggesting that MMP-9 has a protective role in neonatal inflammatory lung injury. The beta6 integrin subunit, an activator of transforming growth factor-beta, is involved in adult lung disease. Absence of the beta6 integrin subunit improves alveolar development in IL-1 beta-expressing mice, suggesting that the beta6 integrin subunit is a pathogenetic factor in inflammatory lung disease in the newborn. The authors of clinical studies who have examined maternal inflammation as a risk factor for BPD have found variable results. We have shown that maternal IL-1 beta production preceding fetal IL-1 beta production prevents lung inflammation, alveolar hypoplasia, and airway remodeling in newborn IL-1 beta expressing mice. Thus, maternal inflammation may protect the newborn lung against subsequent inflammatory injury. In contrast, when maternal and fetal production of IL-1 beta are induced simultaneously, the development of IL-1 beta-induced lung disease in the newborn is not prevented. Semin Perinatol 34:211-221 (C) 2010 Elsevier Inc. All rights reserved.