Fullerton D A, Eisenach J H, Friese R S, Agrafojo J, Sheridan B C, McIntyre R C
Department of Surgery, University of Colorado, Denver, USA.
Surgery. 1996 Nov;120(5):879-84. doi: 10.1016/s0039-6060(96)80098-5.
A major hemodynamic feature of acute lung injury is pulmonary hypertension caused by pulmonary vasoconstriction. Impairment of the mechanisms of pulmonary vasorelaxation may contribute to this pulmonary vasoconstriction. This study examined the effect of mesenteric ischemia/reperfusion (I/R) on lung neutrophil accumulation and endothelial-dependent and -independent cyclic 3'-5' guanosine monophosphate-mediated pulmonary vasorelaxation in rats.
Rats were studied after 1 hour of superior mesenteric artery occlusion and 2 hours of reperfusion. Lung neutrophil accumulation was determined by myeloperoxidase assay (MPO). The following mechanisms of pulmonary vasorelaxation were studied in isolated pulmonary artery rings by generating dose response curves (10(-9) to 10(-6)mol/L): (1) receptor-dependent, endothelial-dependent relaxation (response to acetylcholine), (2) receptor-independent, endothelial-dependent relaxation (response to the calcium ionophore, A23187), and (3) endothelial-independent relaxation (response to sodium nitroprusside [SNP]).
Lung MPO activity was significantly increased from 2.4 +/- 0.2 units/gm lung weight in controls to 10.3 +/- 0.4 after mesenteric I/R (p < 0.05). The vasorelaxation response to SNP was not different after mesenteric I/R, but vasorelaxation by both acetylcholine and A23187 were significantly impaired.
Endothelial-dependent pulmonary vasorelaxation is significantly impaired after mesenteric I/R. Such impairment of pulmonary vasorelaxation may help tip the net balance of pulmonary vasomotor tone toward vasoconstriction and contribute to the pulmonary hypertension seen in acute lung injury.
急性肺损伤的一个主要血流动力学特征是由肺血管收缩引起的肺动脉高压。肺血管舒张机制的损害可能导致这种肺血管收缩。本研究检测了肠系膜缺血/再灌注(I/R)对大鼠肺中性粒细胞聚集以及内皮依赖性和非内皮依赖性环磷酸鸟苷介导的肺血管舒张的影响。
大鼠在肠系膜上动脉闭塞1小时和再灌注2小时后进行研究。通过髓过氧化物酶测定法(MPO)测定肺中性粒细胞聚集。在离体肺动脉环中通过生成剂量反应曲线(10⁻⁹至10⁻⁶mol/L)研究以下肺血管舒张机制:(1)受体依赖性、内皮依赖性舒张(对乙酰胆碱的反应),(2)受体非依赖性、内皮依赖性舒张(对钙离子载体A23187的反应),以及(3)非内皮依赖性舒张(对硝普钠[SNP]的反应)。
肺MPO活性从对照组的2.4±0.2单位/克肺组织显著增加至肠系膜I/R后的10.3±0.4(p<0.05)。肠系膜I/R后对SNP的血管舒张反应无差异,但乙酰胆碱和A23187介导的血管舒张均显著受损。
肠系膜I/R后内皮依赖性肺血管舒张显著受损。这种肺血管舒张的损害可能有助于使肺血管运动张力的净平衡倾向于血管收缩,并导致急性肺损伤中出现的肺动脉高压。