Effets d'une exposition in utero à la nicotine sur le développement et la conduction du système cardiaque chez le lapin

More than 50% of newborns death is due to the sudden infant death syndrome (SIDS). Exposure to cigarette smoke represents the highest risk factor for SIDS. Cardiac bradycardias are observed in most cases of SIDS. The cardiac conduction system is molded by a resorptive degeneration process (apoptosis). Nicotine is known to possess anti-apoptotic effects. Therefore, we hypothesized that nicotine disrupts the maturation of the sinoatrial (SAN) and auriculoventricular (AVN) nodes, which in return can cause arrhythmias leading to SIDS. Methods: Osmotic pumps delivering nicotine were subcutaneously implanted in pregnant rabbits at their second week of pregnancy. We then characterized the level of apoptosis in SAN of newborn rabbits exposed or not to nicotine in utero. Moreover, we did immunofluorescence to localize the sodium channels (Na[subscript v]s) within the SAN. Then, using quantitative PCR, we quantified the expression of Na[subscript v]s in the atria and ventricles of the newborn rabbits' hearts at 0, 7, 14 and 30 days postnatal. Finally, we looked at the effect of isoproterenol on the cardiac sodium channels in rabbits exposed or not to nicotine. Results: Nicotine decreased apoptosis at 7 days postnatal, thus preventing the early development of SAN. At 14 and 30 days when serum nicotine levels dropped to 0 ng/ml, apoptosis reached levels similar to unexposed rabbit hearts at 7 days. Nicotine increased the expression pattern of SCN1A and SCN5A in the right atria of control newborn rabbits. Therefore, at 0 day PN, we observed an increase in the expression of SCN1A, SCN4A and SCN5A of respectively 3, 2 and 15 times. At 7 days PN, I observe an increase of expression of 7, 30 and 64 times for SCN1A, SCN4A and SCN5A respectively. At 14 days PN, I notice an increase in the expression of SCN1A, SCN4A and SCN5A of respectively 2, 3 and 7 times. At 30 days PN, I note an increase of expression of SCN5A by 44 times when exposed to nicotine. Finally, I observe that nicotine removes the effect of isoproterenol on the amplitude of cardiac sodium channels. Conclusion: In conclusion, our study demonstrates that nicotine disturbed the resorptive degeneration process and delays the development of the SAN and regionally perturbed expression of SCN1A, SCN4A and SCN5A. These changes can help explain the conduction disturbances observed in SIDS