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Center for Anesthesia Research, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, 19104-4283
These studies document striking pulmonary
vasoconstrictor response to nitric oxide synthase (NOS) inhibition in
monocrotaline (MCT) pulmonary hypertension in rats. This constriction
is caused by elevated endothelin (ET)-1 production acting on
ETA receptors. Isolated, red blood
cell plus buffer-perfused lungs from rats were studied
3 wk after MCT (60 mg/kg) or saline injection. MCT-injected rats
developed pulmonary hypertension, right ventricular hypertrophy, and
heightened pulmonary vasoconstriction to ANG II and the NOS inhibitor
NG-monomethyl-L-arginine
(L-NMMA). In MCT-injected lungs,
the magnitude of the pulmonary pressor response to NOS inhibition
correlated strongly with the extent of pulmonary hypertension.
Pretreatment of isolated MCT-injected lungs with combined
ETA (BQ-123) plus ETB (BQ-788) antagonists or
ETA antagonist alone prevented the L-NMMA-induced constriction.
Addition of ETA antagonist
reversed established
L-NMMA-induced constriction;
ETB antagonist did not. ET-1
concentrations were elevated in MCT-injected lung perfusate compared
with sham-injected lung perfusate, but ET-1 levels did not differ
before and after NOS inhibition. NOS inhibition enhanced hypoxic
pulmonary vasoconstriction in both sham- and MCT-injected lungs, but
the enhancement was greater in MCT-injected lungs. Results suggest that
in MCT pulmonary hypertension, elevated endogenous ET-1 production
acting through ETA receptors
causes pulmonary vasoconstriction that is normally masked by endogenous
NO production.
pulmonary circulation; pulmonary vascular resistance; endothelial function; nitric oxide
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