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The elucidation of the pathogenesis of lung hypoplasia with CDH, focusing on the abnormalities of the bronchial cartilage and smooth muscle

Research Project

Project/Area Number 19K09101
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 55010:General surgery and pediatric surgery-related
Research InstitutionKyoto Prefectural University of Medicine

Principal Investigator

Tando So  京都府立医科大学, 医学(系)研究科(研究院), 助教 (80423870)

Project Period (FY) 2019-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2020: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
KeywordsCDH / lung hypoplasia / primary cilia / 先天性横隔膜ヘルニア / 気管支軟骨 / 一次繊毛 / 気管軟骨 / 低形成肺
Outline of Research at the Start

先天性横隔膜ヘルニア(CDH)に合併する低形成肺は、CDH患児の最も重要な死因の一つである。本研究では、CDH低形成肺の気道軟骨や平滑筋に着眼し、これら間葉系組織の異常が呼吸障害の一因になっているとの仮説を検証する。具体的には、
(1) ヒトCDH剖検肺を用いた気管支軟骨・平滑筋の組織計測学的解析
(2) 網羅的遺伝子発現解析による気管・気管支軟骨、平滑筋細胞分化に関わる新たなマ-カ-検索とそれらを用いたCDH病態解明
(3)CDHモデルラットを用いた気道平滑筋の発生学的形態・機能異常の検証
を行い、今後の新たなCDH胎児治療法開発へと展開し得る基盤的研究を行う。

Outline of Final Research Achievements

To elucidate the pathogenesis of lung hypoplasia with Congenital diaphragmatic hernia (CDH), we analyzed autopsied lungs using morphological techniques to assess the bronchial cartilage and alveolar maturity. The results indicated that opposite directional cartilage abnormalities around the distal and more proximal bronchi support our hypothesis that abnormal development of bronchial cartilage might play an essential role in the hypoplastic lung in CDH. Next, we showed the abnormalities of the tracheal cartilage in the nitrofen-induced CDH rat and performed the bulk RNA-seq using the E18 trachea of the CDH rat. The data indicated the downregulation of the cilia-related genes. Histologically, the primary cilia lengths in the abnormal cartilage were shorter than those of the control. Moreover, we found the downregulation of MAPKAP1 and pAkt in the abnormal cartilage, suggesting that primary cilia and the mTOR2 might be related to the pathogenesis of the abnormal cartilage in CDH.

Academic Significance and Societal Importance of the Research Achievements

先天性横隔膜ヘルニア(CDH)の重症度は、肺低形成の程度によって左右される。近年、救命率は向上しているが、依然として約20%の重症例は救命できていない。我々は、肺内気管支軟骨の異常が、CDHに伴う肺低形成の病態に深く関与していることを明らかにし、その病因として、一次繊毛の異常があることを示した。CDHの病態を繊毛の異常という観点からとらえなおすことは、新規治療法を考える上で、意義がある。

Report

(6 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (1 results)

All 2020

All Journal Article (1 results) (of which Peer Reviewed: 1 results)

  • [Journal Article] Maldevelopment of intrapulmonary bronchial cartilage in congenital diaphragmatic hernia2020

    • Author(s)
      So Tando, Kohei Sakai, Shohei Takayama, Kenji Fukunaga, Mayumi Higashi, Shigehisa Fumino, Shigeyoshi Aoi, Taizo Furukawa, Tatsuro Tajiri, Hiroshi Ogi, Kyoko Itoh
    • Journal Title

      Pediatric pulmonology

      Volume: -

    • Related Report
      2019 Research-status Report
    • Peer Reviewed

URL: 

Published: 2019-04-18   Modified: 2025-01-30  

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