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Published in: Pediatric Surgery International 7/2008

Open Access 01-07-2008 | Review Article

Congenital diaphragmatic hernia and retinoids: searching for an etiology

Authors: Sandra Montedonico, Nana Nakazawa, Prem Puri

Published in: Pediatric Surgery International | Issue 7/2008

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Abstract

Congenital diaphragmatic hernia (CDH) is a major life-threatening cause of respiratory failure in the newborn. Recent data reveal the role of a retinoid-signaling pathway disruption in the pathogenesis of CDH. We describe the epidemiology and pathophysiology of human CDH, the metabolism of retinoids and the implications of retinoids in the development of the diaphragm and lung. Finally, we describe the existing evidence of a disruption of the retinoid-signaling pathway in CDH.
Literature
1.
go back to reference Stege G, Fenton A, Jaffray B (2003) Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia. Pediatrics 112(3 Pt 1):532–535PubMedCrossRef Stege G, Fenton A, Jaffray B (2003) Nihilism in the 1990s: the true mortality of congenital diaphragmatic hernia. Pediatrics 112(3 Pt 1):532–535PubMedCrossRef
2.
go back to reference Torfs CP, Curry CJ, Bateson TF, Honore LH (1992) A population-based study of congenital diaphragmatic hernia. Teratology 46(6):555–565PubMedCrossRef Torfs CP, Curry CJ, Bateson TF, Honore LH (1992) A population-based study of congenital diaphragmatic hernia. Teratology 46(6):555–565PubMedCrossRef
3.
go back to reference Sweed Y, Puri P (1993) Congenital diaphragmatic hernia: influence of associated malformations on survival. Arch Dis Child 69(1 Spec No):68–70PubMed Sweed Y, Puri P (1993) Congenital diaphragmatic hernia: influence of associated malformations on survival. Arch Dis Child 69(1 Spec No):68–70PubMed
4.
go back to reference Hosgor M, Tibboel D (2004) Congenital diaphragmatic hernia; many questions, few answers. Paediatr Respir Rev 5(Suppl A):S277–S282PubMedCrossRef Hosgor M, Tibboel D (2004) Congenital diaphragmatic hernia; many questions, few answers. Paediatr Respir Rev 5(Suppl A):S277–S282PubMedCrossRef
5.
go back to reference Ontario Congenital Anomalies Study Group (2004) Apparent truth about congenital diaphragmatic hernia: a population-based database is needed to establish benchmarking for clinical outcomes for CDH. J Pediatr Surg 39(5):661–665CrossRef Ontario Congenital Anomalies Study Group (2004) Apparent truth about congenital diaphragmatic hernia: a population-based database is needed to establish benchmarking for clinical outcomes for CDH. J Pediatr Surg 39(5):661–665CrossRef
6.
go back to reference Ivascu FA, Hirschl RB (2004) New approaches to managing congenital diaphragmatic hernia. Semin Perinatol 28(3):185–198PubMedCrossRef Ivascu FA, Hirschl RB (2004) New approaches to managing congenital diaphragmatic hernia. Semin Perinatol 28(3):185–198PubMedCrossRef
7.
go back to reference Doyle NM, Lally KP (2004) The CDH Study Group and advances in the clinical care of the patient with congenital diaphragmatic hernia. Semin Perinatol 28(3):174–184PubMedCrossRef Doyle NM, Lally KP (2004) The CDH Study Group and advances in the clinical care of the patient with congenital diaphragmatic hernia. Semin Perinatol 28(3):174–184PubMedCrossRef
8.
go back to reference Harrison MR, Adzick NS, Bullard KM, Farrell JA, Howell LJ, Rosen MA, et al (1997) Correction of congenital diaphragmatic hernia in utero VII: a prospective trial. J Pediatr Surg 32(11):1637–1642PubMedCrossRef Harrison MR, Adzick NS, Bullard KM, Farrell JA, Howell LJ, Rosen MA, et al (1997) Correction of congenital diaphragmatic hernia in utero VII: a prospective trial. J Pediatr Surg 32(11):1637–1642PubMedCrossRef
9.
go back to reference Harrison MR, Keller RL, Hawgood SB, Kitterman JA, Sandberg PL, Farmer DL et al (2003) A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med 349(20):1916–1924PubMedCrossRef Harrison MR, Keller RL, Hawgood SB, Kitterman JA, Sandberg PL, Farmer DL et al (2003) A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med 349(20):1916–1924PubMedCrossRef
10.
go back to reference Lally KP, Bagolan P, Hosie S, Lally PA, Stewart M, Cotten CM, et al (2006) Corticosteroids for fetuses with congenital diaphragmatic hernia: can we show benefit? J Pediatr Surg 41(4):668–674; discussion 668–674PubMedCrossRef Lally KP, Bagolan P, Hosie S, Lally PA, Stewart M, Cotten CM, et al (2006) Corticosteroids for fetuses with congenital diaphragmatic hernia: can we show benefit? J Pediatr Surg 41(4):668–674; discussion 668–674PubMedCrossRef
12.
go back to reference Mortell A, Montedonico S, Puri P (2006) Animal models in pediatric surgery. Pediatr Surg Int 22(2):111–128PubMedCrossRef Mortell A, Montedonico S, Puri P (2006) Animal models in pediatric surgery. Pediatr Surg Int 22(2):111–128PubMedCrossRef
13.
go back to reference Keijzer R, Liu J, Deimling J, Tibboel D, Post M (2000) Dual-hit hypothesis explains pulmonary hypoplasia in the nitrofen model of congenital diaphragmatic hernia. Am J Pathol 156(4):1299–1306PubMed Keijzer R, Liu J, Deimling J, Tibboel D, Post M (2000) Dual-hit hypothesis explains pulmonary hypoplasia in the nitrofen model of congenital diaphragmatic hernia. Am J Pathol 156(4):1299–1306PubMed
14.
go back to reference Babiuk RP, Greer JJ (2002) Diaphragm defects occur in a CDH hernia model independently of myogenesis and lung formation. Am J Physiol Lung Cell Mol Physiol 283(6):L1310–L1314PubMed Babiuk RP, Greer JJ (2002) Diaphragm defects occur in a CDH hernia model independently of myogenesis and lung formation. Am J Physiol Lung Cell Mol Physiol 283(6):L1310–L1314PubMed
15.
go back to reference Babiuk RP, Zhang W, Clugston R, Allan DW, Greer JJ (2003) Embryological origins and development of the rat diaphragm. J Comp Neurol 455(4):477–487PubMedCrossRef Babiuk RP, Zhang W, Clugston R, Allan DW, Greer JJ (2003) Embryological origins and development of the rat diaphragm. J Comp Neurol 455(4):477–487PubMedCrossRef
16.
go back to reference Blomhoff R, Blomhoff HK (2006) Overview of retinoid metabolism and function. J Neurobiol 66(7):606–630PubMedCrossRef Blomhoff R, Blomhoff HK (2006) Overview of retinoid metabolism and function. J Neurobiol 66(7):606–630PubMedCrossRef
17.
go back to reference DiFiore JW, Wilson JM (1994) Lung development. Semin Pediatr Surg 3(4):221–232PubMed DiFiore JW, Wilson JM (1994) Lung development. Semin Pediatr Surg 3(4):221–232PubMed
18.
19.
go back to reference Malpel S, Mendelsohn C, Cardoso WV (2000) Regulation of retinoic acid signaling during lung morphogenesis. Development 127(14):3057–3067PubMed Malpel S, Mendelsohn C, Cardoso WV (2000) Regulation of retinoic acid signaling during lung morphogenesis. Development 127(14):3057–3067PubMed
20.
go back to reference Dolle P, Fraulob V, Kastner P, Chambon P (1994) Developmental expression of murine retinoid X receptor (RXR) genes. Mech Dev 45(2):91–104PubMedCrossRef Dolle P, Fraulob V, Kastner P, Chambon P (1994) Developmental expression of murine retinoid X receptor (RXR) genes. Mech Dev 45(2):91–104PubMedCrossRef
21.
go back to reference Dolle P, Ruberte E, Leroy P, Morriss-Kay G, Chambon P (1990) Retinoic acid receptors and cellular retinoid binding proteins. I. A systematic study of their differential pattern of transcription during mouse organogenesis. Development 110(4):1133–1151PubMed Dolle P, Ruberte E, Leroy P, Morriss-Kay G, Chambon P (1990) Retinoic acid receptors and cellular retinoid binding proteins. I. A systematic study of their differential pattern of transcription during mouse organogenesis. Development 110(4):1133–1151PubMed
22.
go back to reference Mollard R, Ghyselinck NB, Wendling O, Chambon P, Mark M (2000) Stage-dependent responses of the developing lung to retinoic acid signaling. Int J Dev Biol 44(5):457–462PubMed Mollard R, Ghyselinck NB, Wendling O, Chambon P, Mark M (2000) Stage-dependent responses of the developing lung to retinoic acid signaling. Int J Dev Biol 44(5):457–462PubMed
23.
go back to reference Desai TJ, Malpel S, Flentke GR, Smith SM, Cardoso WV (2004) Retinoic acid selectively regulates Fgf10 expression and maintains cell identity in the prospective lung field of the developing foregut. Dev Biol 273(2):402–415PubMedCrossRef Desai TJ, Malpel S, Flentke GR, Smith SM, Cardoso WV (2004) Retinoic acid selectively regulates Fgf10 expression and maintains cell identity in the prospective lung field of the developing foregut. Dev Biol 273(2):402–415PubMedCrossRef
24.
go back to reference Adamson IY, Bowden DH (1975) Derivation of type 1 epithelium from type 2 cells in the developing rat lung. Lab Invest 32(6):736–745PubMed Adamson IY, Bowden DH (1975) Derivation of type 1 epithelium from type 2 cells in the developing rat lung. Lab Invest 32(6):736–745PubMed
25.
go back to reference Nabeyrat E, Besnard V, Corroyer S, Cazals V, Clement A (1998) Retinoic acid-induced proliferation of lung alveolar epithelial cells: relation with the IGF system. Am J Physiol 275(1 Pt 1):L71–L79PubMed Nabeyrat E, Besnard V, Corroyer S, Cazals V, Clement A (1998) Retinoic acid-induced proliferation of lung alveolar epithelial cells: relation with the IGF system. Am J Physiol 275(1 Pt 1):L71–L79PubMed
26.
go back to reference Hind M, Corcoran J, Maden M (2002) Alveolar proliferation, retinoid synthesizing enzymes, and endogenous retinoids in the postnatal mouse lung. Different roles for Aldh-1 and Raldh-2. Am J Respir Cell Mol Biol 26(1):67–73PubMed Hind M, Corcoran J, Maden M (2002) Alveolar proliferation, retinoid synthesizing enzymes, and endogenous retinoids in the postnatal mouse lung. Different roles for Aldh-1 and Raldh-2. Am J Respir Cell Mol Biol 26(1):67–73PubMed
27.
go back to reference Burri PH (1997) Structural aspects of prenatal and postnatal development and growth of the lung. In: McDonald JA (ed) Lung growth and development. Marcel Dekker, New York, pp 1–35 Burri PH (1997) Structural aspects of prenatal and postnatal development and growth of the lung. In: McDonald JA (ed) Lung growth and development. Marcel Dekker, New York, pp 1–35
28.
go back to reference Dirami G, Massaro GD, Clerch LB, Ryan US, Reczek PR, Massaro D (2004) Lung retinol storing cells synthesize and secrete retinoic acid, an inducer of alveolus formation. Am J Physiol Lung Cell Mol Physiol 286(2):L249–L256PubMedCrossRef Dirami G, Massaro GD, Clerch LB, Ryan US, Reczek PR, Massaro D (2004) Lung retinol storing cells synthesize and secrete retinoic acid, an inducer of alveolus formation. Am J Physiol Lung Cell Mol Physiol 286(2):L249–L256PubMedCrossRef
29.
go back to reference McGowan SE, Torday JS (1997) The pulmonary lipofibroblast (lipid interstitial cell) and its contributions to alveolar development. Annu Rev Physiol 59:43–62PubMedCrossRef McGowan SE, Torday JS (1997) The pulmonary lipofibroblast (lipid interstitial cell) and its contributions to alveolar development. Annu Rev Physiol 59:43–62PubMedCrossRef
30.
go back to reference Sannes PL (1991) Structural and functional relationships between type II pneumocytes and components of extracellular matrices. Exp Lung Res 17(4):639–659PubMedCrossRef Sannes PL (1991) Structural and functional relationships between type II pneumocytes and components of extracellular matrices. Exp Lung Res 17(4):639–659PubMedCrossRef
31.
go back to reference Massaro GD, Massaro D (1996) Postnatal treatment with retinoic acid increases the number of pulmonary alveoli in rats. Am J Physiol 270(2 Pt 1):L305–L310PubMed Massaro GD, Massaro D (1996) Postnatal treatment with retinoic acid increases the number of pulmonary alveoli in rats. Am J Physiol 270(2 Pt 1):L305–L310PubMed
32.
go back to reference Hind M, Maden M (2004) Retinoic acid induces alveolar regeneration in the adult mouse lung. Eur Respir J 23(1):20–27PubMedCrossRef Hind M, Maden M (2004) Retinoic acid induces alveolar regeneration in the adult mouse lung. Eur Respir J 23(1):20–27PubMedCrossRef
33.
go back to reference McGowan S, Jackson SK, Jenkins-Moore M, Dai HH, Chambon P, Snyder JM (2000) Mice bearing deletions of retinoic acid receptors demonstrate reduced lung elastin and alveolar numbers. Am J Respir Cell Mol Biol 23(2):162–167PubMed McGowan S, Jackson SK, Jenkins-Moore M, Dai HH, Chambon P, Snyder JM (2000) Mice bearing deletions of retinoic acid receptors demonstrate reduced lung elastin and alveolar numbers. Am J Respir Cell Mol Biol 23(2):162–167PubMed
34.
go back to reference Massaro GD, Massaro D, Chambon P (2003) Retinoic acid receptor-alpha regulates pulmonary alveolus formation in mice after, but not during, perinatal period. Am J Physiol Lung Cell Mol Physiol 284(2):L431–L433PubMed Massaro GD, Massaro D, Chambon P (2003) Retinoic acid receptor-alpha regulates pulmonary alveolus formation in mice after, but not during, perinatal period. Am J Physiol Lung Cell Mol Physiol 284(2):L431–L433PubMed
35.
go back to reference Massaro GD, Massaro D, Chan WY, Clerch LB, Ghyselinck N, Chambon P et al (2000) Retinoic acid receptor-beta: an endogenous inhibitor of the perinatal formation of pulmonary alveoli. Physiol Genomics 4(1):51–57PubMed Massaro GD, Massaro D, Chan WY, Clerch LB, Ghyselinck N, Chambon P et al (2000) Retinoic acid receptor-beta: an endogenous inhibitor of the perinatal formation of pulmonary alveoli. Physiol Genomics 4(1):51–57PubMed
36.
go back to reference Larsen W (1997) Human Embryology, 2nd edn. Churchill Livingstone, New York Larsen W (1997) Human Embryology, 2nd edn. Churchill Livingstone, New York
37.
go back to reference Allan DW, Greer JJ (1997) Embryogenesis of the phrenic nerve and diaphragm in the fetal rat. J Comp Neurol 382(4):459–468PubMedCrossRef Allan DW, Greer JJ (1997) Embryogenesis of the phrenic nerve and diaphragm in the fetal rat. J Comp Neurol 382(4):459–468PubMedCrossRef
38.
go back to reference Greer JJ, Allan DW, Martin-Caraballo M, Lemke RP (1999) An overview of phrenic nerve and diaphragm muscle development in the perinatal rat. J Appl Physiol 86(3):779–786PubMed Greer JJ, Allan DW, Martin-Caraballo M, Lemke RP (1999) An overview of phrenic nerve and diaphragm muscle development in the perinatal rat. J Appl Physiol 86(3):779–786PubMed
39.
go back to reference Bavik C, Ward SJ, Ong DE (1997) Identification of a mechanism to localize generation of retinoic acid in rat embryos. Mech Dev 69(1–2):155–167PubMedCrossRef Bavik C, Ward SJ, Ong DE (1997) Identification of a mechanism to localize generation of retinoic acid in rat embryos. Mech Dev 69(1–2):155–167PubMedCrossRef
40.
go back to reference Mey J, Babiuk RP, Clugston R, Zhang W, Greer JJ (2003) Retinal dehydrogenase-2 is inhibited by compounds that induce congenital diaphragmatic hernias in rodents. Am J Pathol 162(2):673–679PubMed Mey J, Babiuk RP, Clugston R, Zhang W, Greer JJ (2003) Retinal dehydrogenase-2 is inhibited by compounds that induce congenital diaphragmatic hernias in rodents. Am J Pathol 162(2):673–679PubMed
41.
go back to reference Mendelsohn C, Lohnes D, Decimo D, Lufkin T, LeMeur M, Chambon P, et al (1994) Function of the retinoic acid receptors (RARs) during development (II). Multiple abnormalities at various stages of organogenesis in RAR double mutants. Development 120(10):2749–2771PubMed Mendelsohn C, Lohnes D, Decimo D, Lufkin T, LeMeur M, Chambon P, et al (1994) Function of the retinoic acid receptors (RARs) during development (II). Multiple abnormalities at various stages of organogenesis in RAR double mutants. Development 120(10):2749–2771PubMed
42.
go back to reference Wilson JG, Roth CB, Warkany J (1953) An analysis of the syndrome of malformations induced by maternal vitamin A deficiency. Effects of restoration of vitamin A at various times during gestation. Am J Anat 92(2):189–217PubMedCrossRef Wilson JG, Roth CB, Warkany J (1953) An analysis of the syndrome of malformations induced by maternal vitamin A deficiency. Effects of restoration of vitamin A at various times during gestation. Am J Anat 92(2):189–217PubMedCrossRef
43.
go back to reference Andersen DH (1941) Incidence of congenital diaphragmatic hernia in the young of rats bred on a diet deficient in Vitamin A. Am J Dis Child 62:888–889 Andersen DH (1941) Incidence of congenital diaphragmatic hernia in the young of rats bred on a diet deficient in Vitamin A. Am J Dis Child 62:888–889
44.
go back to reference Major D, Cadenas M, Fournier L, Leclerc S, Lefebvre M, Cloutier R (1998) Retinol status of newborn infants with congenital diaphragmatic hernia. Pediatr Surg Int 13(8):547–549PubMedCrossRef Major D, Cadenas M, Fournier L, Leclerc S, Lefebvre M, Cloutier R (1998) Retinol status of newborn infants with congenital diaphragmatic hernia. Pediatr Surg Int 13(8):547–549PubMedCrossRef
45.
go back to reference Noble BR, Babiuk RP, Clugston RD, Underhill TM, Sun H, Kawaguchi R et al (2007) Mechanisms of action of the congenital diaphragmatic hernia-inducing teratogen nitrofen. Am J Physiol Lung Cell Mol Physiol 293(4):L1079–L1087PubMedCrossRef Noble BR, Babiuk RP, Clugston RD, Underhill TM, Sun H, Kawaguchi R et al (2007) Mechanisms of action of the congenital diaphragmatic hernia-inducing teratogen nitrofen. Am J Physiol Lung Cell Mol Physiol 293(4):L1079–L1087PubMedCrossRef
46.
go back to reference Chen MH, MacGowan A, Ward S, Bavik C, Greer JJ (2003) The activation of the retinoic acid response element is inhibited in an animal model of congenital diaphragmatic hernia. Biol Neonate 83(3):157–161PubMedCrossRef Chen MH, MacGowan A, Ward S, Bavik C, Greer JJ (2003) The activation of the retinoic acid response element is inhibited in an animal model of congenital diaphragmatic hernia. Biol Neonate 83(3):157–161PubMedCrossRef
47.
go back to reference Thebaud B, Tibboel D, Rambaud C, Mercier JC, Bourbon JR, Dinh-Xuan AT et al (1999) Vitamin A decreases the incidence and severity of nitrofen-induced congenital diaphragmatic hernia in rats. Am J Physiol 277(2 Pt 1):L423–L429PubMed Thebaud B, Tibboel D, Rambaud C, Mercier JC, Bourbon JR, Dinh-Xuan AT et al (1999) Vitamin A decreases the incidence and severity of nitrofen-induced congenital diaphragmatic hernia in rats. Am J Physiol 277(2 Pt 1):L423–L429PubMed
48.
go back to reference Baptista MJ, Melo-Rocha G, Pedrosa C, Gonzaga S, Teles A, Estevao-Costa J, et al (2005) Antenatal vitamin A administration attenuates lung hypoplasia by interfering with early instead of late determinants of lung underdevelopment in congenital diaphragmatic hernia. J Pediatr Surg 40(4):658–665PubMedCrossRef Baptista MJ, Melo-Rocha G, Pedrosa C, Gonzaga S, Teles A, Estevao-Costa J, et al (2005) Antenatal vitamin A administration attenuates lung hypoplasia by interfering with early instead of late determinants of lung underdevelopment in congenital diaphragmatic hernia. J Pediatr Surg 40(4):658–665PubMedCrossRef
49.
go back to reference Oshiro T, Asato Y, Sakanashi M, Ohta T, Sugahara K (2005) Differential effects of vitamin A on fetal lung growth and diaphragmatic formation in nitrofen-induced rat model. Pulm Pharmacol Ther 18(3):155–164PubMedCrossRef Oshiro T, Asato Y, Sakanashi M, Ohta T, Sugahara K (2005) Differential effects of vitamin A on fetal lung growth and diaphragmatic formation in nitrofen-induced rat model. Pulm Pharmacol Ther 18(3):155–164PubMedCrossRef
50.
go back to reference Babiuk RP, Thebaud B, Greer JJ (2004) Reductions in the incidence of nitrofen-induced diaphragmatic hernia by vitamin A and retinoic acid. Am J Physiol Lung Cell Mol Physiol 286(5):L970–L973PubMedCrossRef Babiuk RP, Thebaud B, Greer JJ (2004) Reductions in the incidence of nitrofen-induced diaphragmatic hernia by vitamin A and retinoic acid. Am J Physiol Lung Cell Mol Physiol 286(5):L970–L973PubMedCrossRef
51.
go back to reference Nakazawa N, Takayasu H, Montedonico S, Puri P (2007) Altered regulation of retinoic acid synthesis in nitrofen-induced hypoplastic lung. Pediatr Surg Int 23(5):391–396PubMedCrossRef Nakazawa N, Takayasu H, Montedonico S, Puri P (2007) Altered regulation of retinoic acid synthesis in nitrofen-induced hypoplastic lung. Pediatr Surg Int 23(5):391–396PubMedCrossRef
52.
go back to reference Nakazawa N, Montedonico S, Takayasu H, Paradisi F, Puri P (2007) Disturbance of retinol transportation causes nitrofen-induced hypoplastic lung. J Pediatr Surg 42(2):345–349PubMedCrossRef Nakazawa N, Montedonico S, Takayasu H, Paradisi F, Puri P (2007) Disturbance of retinol transportation causes nitrofen-induced hypoplastic lung. J Pediatr Surg 42(2):345–349PubMedCrossRef
53.
go back to reference Montedonico S, Nakazawa N, Puri P (2006) Retinoic acid rescues lung hypoplasia in nitrofen-induced hypoplastic foetal rat lung explants. Pediatr Surg Int 22(1):2–8PubMedCrossRef Montedonico S, Nakazawa N, Puri P (2006) Retinoic acid rescues lung hypoplasia in nitrofen-induced hypoplastic foetal rat lung explants. Pediatr Surg Int 22(1):2–8PubMedCrossRef
54.
go back to reference Montedonico S, Sugimoto K, Felle P, Bannigan J, Puri P (2008) Prenatal treatment with retinoic acid promotes pulmonary alveologenesis in the nitrofen model of congenital diaphragmatic hernia. J Pediatr Surg 43(3):500–507PubMedCrossRef Montedonico S, Sugimoto K, Felle P, Bannigan J, Puri P (2008) Prenatal treatment with retinoic acid promotes pulmonary alveologenesis in the nitrofen model of congenital diaphragmatic hernia. J Pediatr Surg 43(3):500–507PubMedCrossRef
55.
go back to reference Sugimoto K, Takayasu H, Nakazawa N, Montedonico S, Puri P (2008) Prenatal treatment with retinoic acid accelerates type 1 alveolar cell proliferation of the hypoplastic lung in the nitrofen model of congenital diaphragmatic hernia. J Pediatr Surg 43(2):367–372PubMedCrossRef Sugimoto K, Takayasu H, Nakazawa N, Montedonico S, Puri P (2008) Prenatal treatment with retinoic acid accelerates type 1 alveolar cell proliferation of the hypoplastic lung in the nitrofen model of congenital diaphragmatic hernia. J Pediatr Surg 43(2):367–372PubMedCrossRef
Metadata
Title
Congenital diaphragmatic hernia and retinoids: searching for an etiology
Authors
Sandra Montedonico
Nana Nakazawa
Prem Puri
Publication date
01-07-2008
Publisher
Springer-Verlag
Published in
Pediatric Surgery International / Issue 7/2008
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-008-2140-x

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