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Increased pulmonary vascular expression of Krüppel-like factor 5 and activated survivin in experimental congenital diaphragmatic hernia.
[congenital diaphragmatic hernia]
The
high
morbidity
and
mortality
in
congenital
diaphragmatic
hernia
(
CDH
)
is
attributed
to
pulmonary
hypoplasia
and
persistent
pulmonary
hypertension
(
PH
)
.
PH
is
characterized
by
increased
pulmonary
artery
smooth
muscle
cell
(
SMC
)
proliferation
,
suppressed
apoptosis
as
well
as
endothelial
dysfunction
.
Krüppel-like
factor
5
(
KLF
5
)
belongs
to
a
family
of
transcription
factors
that
has
diverse
functions
during
cell
differentiation
and
embryonic
development
.
KLF
5
is
preferentially
expressed
in
proliferating
SMCs
but
reduced
in
differentiated
cells
.
KLF
5
induces
the
expression
of
Survivin
,
a
16
.
5
Â
kDa
protein
overexpressed
in
almost
all
malignancies
but
hardly
detected
in
normal
differentiated
tissues
.
Survivin
has
been
shown
to
inhibit
apoptosis
,
promote
cell
proliferation
,
and
enhance
angiogenesis
.
Recent
studies
have
implicated
activation
of
KLF
5
and
Survivin
in
the
pathogenesis
of
human
and
experimental
PH
.
We
designed
this
study
to
investigate
the
hypothesis
that
KLF
5
and
Survivin
expression
are
increased
in
nitrofen-induced
CDH
.
Pregnant
rats
were
exposed
to
nitrofen
or
vehicle
on
D
9
.
Fetuses
were
sacrificed
on
D
21
and
divided
into
nitrofen
(
n
Â
=
Â
16
)
and
control
group
(
n
Â
=
Â
16
)
.
Quantitative
real-time
PCR
,
western
blotting
,
and
confocal
immunofluorescence
were
performed
to
determine
pulmonary
gene
expression
levels
and
protein
expression
of
KLF
5
,
Survivin
,
and
phosphorylated
Survivin
(
p
-
Survivin
)
.
Confocal
microscopy
revealed
markedly
increased
pulmonary
vascular
KLF
5
and
p
-
Survivin
expression
in
lungs
of
nitrofen-exposed
fetuses
compared
to
controls
.
These
results
were
confirmed
by
western
blotting
,
showing
increased
pulmonary
expression
of
KLF
5
and
p
-
Survivin
.
Furthermore
,
the
relative
pulmonary
gene
expressions
of
KLF
5
and
Survivin
were
significantly
increased
in
the
CDH
group
compared
to
controls
(
p
Â
<
Â
0
.
005
rsp
.
p
Â
<
Â
0
.
01
)
.
This
study
provides
striking
evidence
of
increased
gene
and
protein
expression
of
KLF
5
and
activated
Survivin
in
the
pulmonary
vasculature
of
nitrofen-induced
CDH
,
suggesting
that
increased
expression
of
KLF
5
may
activate
p
-
Survivin
expression
and
play
an
important
role
in
the
pathogenesis
of
PH
in
nitrofen-induced
CDH
.
Diseases
Validation
Diseases presenting
"protein expression of klf5"
symptom
congenital diaphragmatic hernia
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