Airway Expression of the Epithelial Sodium Channel α-Subunit Correlates With Cortisol in Term Newborns

Abstract

BACKGROUND: Glucocorticoids have profound effects on lung maturation and function. In in vitro and animal models, they induce epithelial sodium channels (ENaCs) in the airway epithelium, a process that is important to perinatal lung fluid clearance. OBJECTIVE: The objective of this study was to determine whether, in newborn infants, airway ENaC expression is associated with cortisol concentrations. METHODS: Cord blood, saliva, and cells from nasal epithelium were obtained from 69 infants delivered at term. Epithelial and saliva sampling was repeated 3 times: <3, 22 to 29, and 40 to 54 hours postnatally. Cortisol, thyrotropin, and free triiodothyronine concentrations were measured with immunoassays, and expression of α-ENaC and β-ENaC was quantified with real-time reverse-transcriptase polymerase chain reaction. RESULTS: Expression of α-ENaC <30 minutes postnatally correlated with cord plasma cortisol in infants delivered by elective cesarean delivery. In addition, in the total study population <2 hours postnatally, α-ENaC expression correlated with salivary cortisol concentrations. β-ENaC expression, in contrast, showed no association with cortisol concentrations. A significant decrease in β-ENaC expression during the first postnatal day was revealed, whereas timing of the peak in α-ENaC expression seemed to depend on mode of delivery. CONCLUSIONS: These results support a role in humans for endogenous glucocorticoids in the regulation of airway ion transport. This finding may be a physiologic mechanism mediating pulmonary adaptation in the newborn infant.