Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Antioxid Redox Signal. 2013 May 10;18(14):1727-38. doi: 10.1089/ars.2012.4823. Epub 2013 Jan 29.
There are no effective treatments for chronic pulmonary hypertension in infants with cardiopulmonary disorders associated with hypoxia, such as those with chronic lung disease. These patients often have poor or inconsistent pulmonary dilator responses to inhaled nitric oxide (iNO) therapy for unknown reasons. One possible explanation for poor responsiveness to iNO is reduced NO bioavailability caused by interactions between reactive oxygen species (ROS) and NO. Our major aim was to determine if strategies to reduce ROS improve dilator responses to the NO donor, S-nitroso-N-acetyl-penicillamine (SNAP), in resistance pulmonary arteries (PRAs) from a newborn piglet model of chronic pulmonary hypertension.
The dilation to SNAP was significantly impaired in PRAs from piglets with chronic hypoxia-induced pulmonary hypertension. ROS scavengers, including cell-permeable and impermeable agents to degrade hydrogen peroxide (H(2)O(2)), improved dilation to SNAP in PRAs from chronically hypoxic piglets. Treatment with agents to inhibit nitric oxide synthase and NADPH oxidase, potential enzymatic sources of ROS, also improved dilation to SNAP in PRAs from hypoxic piglets.
Our studies are the first to utilize a newborn model of chronic pulmonary hypertension to evaluate the impact of a number of potential therapeutic strategies for ROS removal on responses to exogenous NO in the vessels most relevant to the regulation of pulmonary vascular resistance (PRA).
Strategies aimed at reducing ROS merit further evaluation and consideration as therapeutic approaches to improve responses to iNO in infants with chronic pulmonary hypertension.
对于伴有缺氧的心肺疾病的婴儿慢性肺动脉高压,如慢性肺部疾病患者,目前尚无有效的治疗方法。由于未知原因,这些患者对吸入性一氧化氮(iNO)治疗往往表现出肺扩张反应不佳或不一致。对 iNO 反应不佳的一个可能解释是,由于活性氧(ROS)与 NO 之间的相互作用,导致 NO 生物利用度降低。我们的主要目的是确定减少 ROS 的策略是否可以改善对 NO 供体 S-亚硝基-N-乙酰青霉胺(SNAP)的扩张反应,这是一种来自慢性肺动脉高压新生仔猪模型的阻力性肺动脉。
在慢性低氧性肺动脉高压仔猪的肺动脉中,SNAP 的扩张明显受损。ROS 清除剂,包括可穿透和不可穿透的过氧化氢(H2O2)降解剂,改善了慢性低氧仔猪肺动脉中 SNAP 的扩张。抑制一氧化氮合酶和 NADPH 氧化酶的药物(ROS 的潜在酶源)的治疗也改善了低氧仔猪肺动脉中 SNAP 的扩张。
我们的研究首次利用新生仔猪慢性肺动脉高压模型,评估了多种潜在的 ROS 清除治疗策略对血管中内源性 NO 反应的影响,这些血管与肺血管阻力(PRA)的调节最为相关。
旨在减少 ROS 的策略值得进一步评估和考虑,作为改善慢性肺动脉高压婴儿对 iNO 反应的治疗方法。