LAUSR

Abnormalities of the airway smooth muscle (ASM) layer in asthma may develop before birth. We hypothesise that antenatal inflammation causes physiological abnormalities of the ASM that predisposes to asthma. This study determined the short-term effects of antenatal inflammation on the developing ASM. Fourteen pregnant ewes were randomly assigned to one of three groups. Fetal lambs were exposed to intra-amniotic injections of lipopolysaccharide (LPS, n=4) or saline (controls; n=5) at 127 days' gestational age (GA). Preterm lambs were surgically delivered at 129 days' GA and received intensive care for 7 days before euthanasia. Naïve fetal controls (n=5) were delivered and euthanased at 136 days' GA. ASM force to acetylcholine was measured in bronchial rings and normalized to ring length (tension) and ASM cross-sectional area (stress). Airway narrowing (% volume) to acetylcholine was assessed in bronchial segments. Fetal controls were structurally and functionally similar to saline-exposed lambs. Compared with saline, LPS-exposed lambs had increased macrophages in lung tissue (P=0.0002) and interleukin-8 in alveolar wash (P=0.003). LPS-exposure increased ASM thickness (P=0.005), airway narrowing (P=0.003), ASM tension (P=0.0002), and contractile stress (P<0.0001). Notably, LPS-exposed lambs were more dependent on mechanical ventilation, and both LPS (P<0.001) and ventilation (P=0.012) were independent factors in increasing ASM stress. Only LPS independently increased ASM thickness (P=0.045). Results indicate that antenatal exposure to LPS and subsequent mechanical ventilation promotes intrinsic changes to the ASM that enhances bronchoconstriction. If persistent into postnatal life, these developmental abnormalities may contribute to the known association between chorioamnionitis and asthma.