Effect of NAC and vitamin D on pulmonary hypoplasia in rats with nitrofen-induced congenital diaphragmatic hernia

Purpose: This study investigated the effects of N-acetyl-cysteine (NAC) and vitamin D, separately and in combination, on pulmonary hypoplasia in rats with nitrofen-induced congenital diaphragmatic hernia (CDH). Materials and methods: Pregnant Sprague-Dawley rats were divided into 5 groups: control (C), nitrofen (N), N+NAC, N+VitD, and N+NAC+VitD. Rats, except group C, received 200 mg nitrofen on day 9.5 of gestation. NAC and vitamin D were administered for four days starting on day 16. The lungs of rats born on day 21-22 were dissected and examined morphologically, histopathologically, and immunohistochemically (transforming growth factor β1 (TGF-β1) and surfactant protein A (SP-A)). Results: Lung/body weight was significantly lower in group N than in group C. The pulmonary epithelial type was mostly mature in the treatment groups and immature in group N (p<0,05). Alveolar thickness was significantly increased in group N compared to the others. TGF-β1 expression was significantly increased while SP-A was decreased in group N compared to the others. SP-A expression was significantly increased in groups C and N+NAC+VitD compared to groups N+NAC and N+VitD. Conclusion: Vitamin D and NAC reduced pulmonary hypoplasia in rats with CDH. Although increased SP-A expression suggests that their combined use is more effective, other results do not support this.