The process of perinatal lung maturation includes remarkable changes in lung tissue architecture, cell differentiation, and gene expression, upon which respiration at birth depends. At the transcriptional level, pulmonary maturation is controlled by the concerted actions of a group of transcription factors mediating gene expression in the lung. An interacting network of transcription factors that includes TTF-1, FOXA2, and C/EBPα is an important regulator of gene expression in the respiratory epithelium that, in turn, influence maturational events in cells throughout the lung. Likewise, glucocorticoids (via the GR) acting primarily in the pulmonary mesenchyme, influence maturational processes in the respiratory epithelium. Elucidation of the intersecting pathways that control perinatal lung function may provide opportunities to induce pulmonary maturation in preterm infants at risk for RDS before birth, and will help identify genes and processes important for various aspects of lung function.
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