Compartmentalized lung cytokine release in response to intravascular and alveolar endotoxin challenge.

Lung cytokine generation has been implicated in pulmonary injury and systemic inflammatory responses. In bufferperfused rabbit lungs, intravascular endotoxin (10 ng/ml perfusate; total amount 7 micrograms) provoked the liberation of 212,100 +/- 119,700 pg tumor necrosis factor-alpha (TNF-alpha) into the vascular space within 3 h. This was augmented to 3,564,400 +/- 1,285,900 pg in the presence of 1% serum. Bronchoalveolar lavages demonstrated the absence of buffer-admixed endotoxin and transition of only minor fractions of the vascular TNF-alpha load into the alveolar space. Aerosolization of 22 micrograms endotoxin liberated 824,400 +/- 48,750 pg TNF-alpha into the alveolar compartment, which was even increased to 16,980,000 +/- 6,066,350 pg on co-nebulization of serum. No endotoxin and only minor amounts of the alveolar TNF-alpha burden spilled over into the vascular compartment. Vascular pressures and lung vascular permeability did not change. We conclude that both intravascular and alveolar endotoxin challenge provokes excessive lung TNF-alpha generation, amplified manyfold in the presence of small serum quantities. For both routes of application, however, the cytokine responses were found to be largely compartmentalized under the given conditions of integer lung barrier properties.