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Am J Physiol Lung Cell Mol Physiol 290: L1078-L1086, 2006. First published January 6, 2006; doi:10.1152/ajplung.00239.2005
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Ventilator-induced lung injury is reduced in transgenic mice that overexpress endothelial nitric oxide synthase

Kaori Takenaka, Yoshihiro Nishimura, Teruaki Nishiuma, Akihiro Sakashita, Tomoya Yamashita, Kazuyuki Kobayashi, Miyako Satouchi, Tatsuro Ishida, Seinosuke Kawashima, and Mitsuhiro Yokoyama

Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan

Submitted 1 June 2005 ; accepted in final form 28 December 2005

Although mechanical ventilation (MV) is an important supportive strategy for patients with acute respiratory distress syndrome, MV itself can cause a type of acute lung damage termed ventilator-induced lung injury (VILI). Because nitric oxide (NO) has been reported to play roles in the pathogenesis of acute lung injury, the present study explores the effects on VILI of NO derived from chronically overexpressed endothelial nitric oxide synthase (eNOS). Anesthetized eNOS-transgenic (Tg) and wild-type (WT) C57BL/6 mice were ventilated at high or low tidal volume (VT; 20 or 7 ml/kg, respectively) for 4 h. After MV, lung damage, including neutrophil infiltration, water leakage, and cytokine concentration in bronchoalveolar lavage fluid (BALF) and plasma, was evaluated. Some mice were given N{omega}-nitro-L-arginine methyl ester (L-NAME), a potent NOS inhibitor, via drinking water (1 mg/ml) for 1 wk before MV. Histological analysis revealed that high VT ventilation caused severe VILI, whereas low VT ventilation caused minimal VILI. Under high VT conditions, neutrophil infiltration and lung water content were significantly attenuated in eNOS-Tg mice compared with WT animals. The concentrations of macrophage inflammatory protein-2 in BALF and plasma, as well as plasma tumor necrosis factor-{alpha} and monocyte chemoattractant protein-1, also were decreased in eNOS-Tg mice. L-NAME abrogated the beneficial effect of eNOS overexpression. In conclusion, chronic eNOS overexpression may protect the lung from VILI by inhibiting the production of inflammatory chemokines and cytokines that are associated with neutrophil infiltration into the air space.

nitric oxide; acute lung injury; mechanical ventilation; macrophage inflammatory protein-2; macrophage chemoattractant protein-1



Address for reprint requests and other correspondence: Y. Nishimura, Division of Cardiovascular and Respiratory Medicine, Kobe Univ. Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan (e-mail: nishiy{at}med.kobe-u.ac.jp)




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