| Hydrocortisone preserves the vascular barrier by protecting the endothelial glycocalyx. | |
| | |
MedLine Citation:
|
PMID: 18073553 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Hydrocortisone protects against ischemia-reperfusion injury, reduces paracellular permeability for macromolecules, and is routinely applied in the prevention of interstitial edema. Healthy vascular endothelium is coated by the endothelial glycocalyx, diminution of which increases capillary permeability, suggesting that the glycocalyx is a target for hydrocortisone action. METHODS: Isolated guinea pig hearts were perfused with Krebs-Henseleit buffer. Hydrocortisone was applied in a stress dose (10 microg/ml) before inducing 20 min of ischemia (37 degrees C). Hearts were reperfused for 20 min at constant flow (baseline perfusion pressure, 70 cm H2O) with Krebs-Henseleit buffer or Krebs-Henseleit buffer plus 2 g% hydroxyethyl starch (130 kd). Coronary net fluid filtration was assessed directly by measuring transudate formation on the epicardial surface. Hearts were perfusion fixed to visualize the glycocalyx. RESULTS: Ischemia-induced degradation of the glycocalyx enhanced coronary perfusion pressure (118.8 +/- 17.3 cm H2O) and increased vascular permeability (8 +/- 0.2 microl x min(-1) x cm H2O(-1) at baseline vs. 34 +/- 3.3 microl x min(-1) x cm H2O(-1) after reperfusion). Enzymatic digestion of the glycocalyx (heparinase) elicited similar effects. Hydrocortisone reduced postischemic oxidative stress, perfusion pressure (86.3 +/- 6.4 cm H2O), and transudate formation (11 +/- 0.6 microl x min(-1) x cm H2O(-1)). Applying colloid augmented this (70.6 +/- 5.6 cm H2O and 9 +/- 0.5 microl x min(-1) x cm H2O(-1)). Postischemic shedding of syndecan-1, heparan sulfate, and hyaluronan was inhibited by hydrocortisone, as was release of histamine from resident mast cells. Electron microscopy revealed a mostly intact glycocalyx after hydrocortisone treatment, but not after heparinase treatment. CONCLUSIONS: Hydrocortisone preserves the endothelial glycocalyx, sustaining the vascular barrier and reducing interstitial edema. The effect of colloids suggests that prevention of postischemic rise in coronary resistance by hydrocortisone could also be based on alleviation of endothelial swelling. Stabilization of myocardial mast cells by hydrocortisone may account for the mitigated inflammatory affect of ischemia-reperfusion. |
| | |
Authors:
|
Daniel Chappell; Matthias Jacob; Klaus Hofmann-Kiefer; Dirk Bruegger; Markus Rehm; Peter Conzen; Ulrich Welsch; Bernhard F Becker |
Related Documents
:
|
17545483 - Three distinct phases of vf during global ischemia in the isolated blood-perfused pig h... 3663023 - Inotropic changes in ischaemic and non-ischaemic myocardium and arrhythmias within the ... 12498243 - Voltage-addressable on/off microvalves for high-pressure microchip separations. |
Publication Detail:
|
Type: In Vitro; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Anesthesiology Volume: 107 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2007 Nov |
Date Detail:
|
Created Date: 2007-12-12 Completed Date: 2008-01-15 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
|
Languages: eng Pagination: 776-84 Citation Subset: AIM; IM |
Affiliation:
|
Clinic of Anesthesiology, Ludwig-Maximilians University Munich, Munich, Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Anti-Inflammatory Agents / pharmacology* Blood Pressure / drug effects Capillary Permeability / drug effects Endothelium, Vascular / drug effects* Extravasation of Diagnostic and Therapeutic Materials / metabolism Exudates and Transudates / drug effects Glucose / administration & dosage Glycocalyx / drug effects*, metabolism, ultrastructure Guinea Pigs Heart / drug effects*, physiology Hetastarch / administration & dosage Histamine / metabolism Hydrocortisone / pharmacology* Male Microscopy, Electron Oxidative Stress / drug effects Plasma Substitutes / administration & dosage Reperfusion Injury / complications Time Factors Tromethamine / administration & dosage |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Inflammatory Agents; 0/Krebs-Henseleit solution; 0/Plasma Substitutes; 50-23-7/Hydrocortisone; 50-99-7/Glucose; 51-45-6/Histamine; 77-86-1/Tromethamine; 9005-27-0/Hetastarch |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cerebral air emboli differentially alter outcome after cardiopulmonary bypass in rats compared with ...
Next Document: Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volu...