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Hypoxic Pulmonary Hypertension of the Newborn

  1. Yuansheng Gao1,
  2. J Usha Raj2

Published Online: 1 NOV 2010

DOI: 10.1002/cphy.c090015

Comprehensive Physiology

Comprehensive Physiology

How to Cite

Gao, Y. and Raj, J. U. 2010. Hypoxic Pulmonary Hypertension of the Newborn. Comprehensive Physiology. 1:61–79.

Author Information

  1. 1

    Department of Physiology and Pathophysiology, Peking University, Health Science Center, Beijing, China

  2. 2

    Department of Pediatrics, College of Medicine at Chicago, University of Illinois, Chicago, IL

Publication History

  1. Published Online: 1 NOV 2010

Abstract

Hypoxic pulmonary hypertension of the newborn is characterized by elevated pulmonary vascular resistance and pressure due to vascular remodeling and increased vessel tension secondary to chronic hypoxia during the fetal and newborn period. In comparison to the adult, the pulmonary vasculature of the fetus and the newborn undergoes tremendous developmental changes that increase susceptibility to a hypoxic insult. Substantial evidence indicates that chronic hypoxia alters the production and responsiveness of various vasoactive agents such as endothelium-derived nitric oxide, endothelin-1, prostanoids, platelet-activating factor, and reactive oxygen species, resulting in sustained vasoconstriction and vascular remodeling. These changes occur in most cell types within the vascular wall, particularly endothelial and smooth muscle cells. At the cellular level, suppressed nitric oxide-cGMP signaling and augmented RhoA-Rho kinase signaling appear to be critical to the development of hypoxic pulmonary hypertension of the newborn. © 2011 American Physiological Society. Compr Physiol 1:61-79, 2011.