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15.1 - Fetal lung growth, development, and lung fluid

Physiology and pathophysiology

from Section 2 - Fetal disease

Published online by Cambridge University Press:  05 February 2013

By
Richard Harding ,
Foula Sozo ,
Takushi Hanita  and
Cheryl Albuquerque
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson
Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center
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Summary

Introduction

The lung develops in utero as a secretory, gland-like organ, and for normal growth and development to occur the lung must be maintained in an expanded state during at least the latter half of gestation. A considerable amount of research in recent years has gone into understanding how lung development is regulated at the molecular level, and also how the lung’s physicochemical environment affects its development. In this chapter we focus on how normal lung development is regulated before birth, and how it is affected by the intrauterine environment. Indeed, there is now a large body of evidence indicating that alterations in lung development that occur during fetal and early postnatal life can persist throughout life, and can impair adult lung function and accelerate the age-related decline in lung function. Lung development is completed during early postnatal life; therefore, after infancy there is limited scope for repairing abnormal lung development. Thus, it is important to be able to detect alterations in lung development early in life, and to understand the processes involved in normal lung development in order to be able to devise therapies to normalize any major alterations. We begin by presenting a brief overview of fetal lung development.

Normal lung development

In order to understand how the lung can be affected by intrauterine conditions, it is important to appreciate how the lung develops. The lung develops as an essentially tubular structure of increasing complexity due to complex interactions between cells of endodermal and mesenchymal origin. At least four or five distinct stages of lung development are recognized, based on microscopic appearance: these are the embryonic, pseudoglandular, canalicular, and saccular-alveolar stages [1]. A final stage of microvascular maturation can also be recognized [2]. These stages of lung development overlap and are conserved between species, although the timing of each stage differs [3].

Keywords

lung liquidlung expansionlung hyperplasialung hypoplasialung developmentfetal breathing movementsintrauterine environment
Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 271 - 281
Publisher: Cambridge University Press
Print publication year: 2012

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