Document Detail


Cyclooxygenase inhibition in ventilator-induced lung injury.
MedLine Citation:
PMID:  21048090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We tested the hypothesis that inhibition of cyclooxygenase (COX) attenuates in vivo ventilator-induced lung injury (VILI) in a prospective, randomized laboratory investigation in a university-affiliated laboratory. Adult male rats were anesthetized and randomized with or without nonselective COX inhibition (ibuprofen) and were subjected to injurious mechanical ventilation (positive end-expiratory pressure = 0; peak inspiratory pressure = 21 mm Hg).
METHODS: We investigated the profile of VILI (respiratory mechanics, cytokines, eicosanoids), expression of COX enzymes, and activation of nuclear factor (NF)-κB in ibuprofen- versus vehicle-treated animals. Injurious ventilation caused lung injury (i.e., decrement in compliance, tissue edema, and elevated inflammatory cytokines, eicosanoids, and COX-2).
RESULTS: Pretreatment with ibuprofen that effectively inhibited eicosanoid synthesis and COX-2 activity increased survival and attenuated lung edema and decrement in respiratory mechanics. Ibuprofen had no modulatory effect on ventilator-induced activation of NF-κB or inflammatory cytokines (tumor necrosis factor-α, interleukin [IL]-1β, IL-6, GRO/KC [growth-related oncogene/keratinocyte chemoattractant]). COX activity seems important in the pathogenesis of VILI in the in vivo rat. Inhibition of COX provides significant protection (i.e., survival, pulmonary function) in VILI, but without affecting levels of important mediators (tumor necrosis factor-α, IL-1β, IL-6, GRO/KC) or activation of NF-κB.
CONCLUSIONS: These data confirm that nonselective COX inhibition provides partial protection against VILI and that the NF-κB signaling pathway is not exclusively eicosanoid dependent. Studies of COX inhibition in ventilator-associated lung injury might benefit from multimodal targeting that includes a comprehensive focus on inflammatory cytokines and NF-κB.
Authors:
Takehiro Niitsu; Shinya Tsuchida; Vanya Peltekova; Doreen Engelberts; Ian Copland; Gail Otulakowski; Martin Post; Brian P Kavanagh
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-03
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  112     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-21     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  143-9     Citation Subset:  AIM; IM    
Affiliation:
Program in Physiology & Experimental Medicine, Hospital for Sick Children, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Gas Analysis / methods
Cyclooxygenase Inhibitors / therapeutic use*
Male
Prospective Studies
Random Allocation
Rats
Rats, Sprague-Dawley
Ventilator-Induced Lung Injury / drug therapy*,  enzymology*
Grant Support
ID/Acronym/Agency:
MOP-15272//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Cyclooxygenase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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