Mikawa Katsuya, Nishina Kahoru, Takao Yumiko, Obara Hidefumi
From the Department of Anesthesia & Perioperative Medicine, Faculty of Medical Sciences, Kobe University Graduate School of Medicine, Kobe, Japan.
Anesth Analg. 2003 Dec;97(6):1751-1755. doi: 10.1213/01.ANE.0000086896.90343.13.
Overproduction of nitric oxide by inducible nitric oxide synthase (iNOS) expressed in the lung is thought to play a crucial role in the pathogenesis of endotoxin-induced acute lung injury (ALI). In this two-part study, we determined whether ONO-1714, a new selective iNOS inhibitor, attenuates endotoxin-induced ALI in rabbits. For Part I of the study, a control group received IV saline and ALI was induced by IV infusion of endotoxin 5 mg/kg over 30 min in 4 groups. Three groups received either 0.1, 0.03, or 0.01 mg/kg of ONO-1714 10 min before the start of endotoxin and the fourth group received saline. For Part II of the study, ALI was induced by endotoxin infusion in all 6 groups. One group was treated with saline. The other 5 groups received ONO-1714 0.1 mg/kg at various timings (10 min before or 1, 2, 3, or 4 h after ALI induction). The lungs were mechanically ventilated with 40% oxygen for 6 h after induction of ALI. In Part I, pretreatment with 0.1 mg/kg ONO-1714 mitigated endotoxin-induced ALI. In Part II, early posttreatment (within 2 h after the insult) with ONO-1714 was as effective as pretreatment in improving oxygenation, lung mechanics, lung leukosequestration, pulmonary edema, and histological change. However, lung damage was not improved in rabbits receiving the drug 3 or 4 h after endotoxin. These data suggest that the current study is a basis for future clinical trials to elucidate whether ONO-1714 can be a promising therapeutic approach in patients with acute respiratory distress syndrome induced by endotoxin/sepsis.
An excess of nitric oxide is thought to play a crucial role in the pathogenesis of acute organ injury in endotoxemia. Early posttreatment with ONO-1714, a nitric oxide synthase inhibitor, attenuated physiological, biochemical, and pathological changes in endotoxin-induced acute lung injury in rabbits.
肺中诱导型一氧化氮合酶(iNOS)过度产生一氧化氮被认为在内毒素诱导的急性肺损伤(ALI)发病机制中起关键作用。在这项分为两部分的研究中,我们确定新型选择性iNOS抑制剂ONO-1714是否能减轻家兔内毒素诱导的ALI。在研究的第一部分,对照组静脉注射生理盐水,4组通过在30分钟内静脉输注5mg/kg内毒素诱导ALI。3组在开始输注内毒素前10分钟分别接受0.1、0.03或0.01mg/kg的ONO-1714,第四组接受生理盐水。在研究的第二部分,所有6组均通过输注内毒素诱导ALI。一组用生理盐水治疗。其他5组在不同时间点(ALI诱导前10分钟或诱导后1、2、3或4小时)接受0.1mg/kg的ONO-1714。ALI诱导后,肺用40%氧气机械通气6小时。在第一部分中,用0.1mg/kg ONO-1714预处理可减轻内毒素诱导的ALI。在第二部分中,ONO-1714早期治疗(损伤后2小时内)在改善氧合、肺力学、肺白细胞扣押、肺水肿和组织学变化方面与预处理同样有效。然而,内毒素后3或4小时接受药物治疗的家兔肺损伤未得到改善。这些数据表明,本研究为未来临床试验奠定了基础,以阐明ONO-1714是否可能成为内毒素/脓毒症诱导的急性呼吸窘迫综合征患者有前景的治疗方法。
一氧化氮过量被认为在内毒素血症急性器官损伤发病机制中起关键作用。一氧化氮合酶抑制剂ONO-1714早期治疗减轻了家兔内毒素诱导的急性肺损伤的生理、生化和病理变化。