Document Detail

Ischemic and endotoxin pre-conditioning reduce lung reperfusion injury-induced surfactant alterations.
MedLine Citation:
PMID:  16210147     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pulmonary ischemia/reperfusion injury represents a common clinical phenomenon after lung transplantation, pulmonary embolism, and cardiac surgery with extracorporeal circulation. We investigated the influence of ischemic and endotoxin pre-conditioning on gas exchange and surfactant properties in a canine model of ischemia/reperfusion injury. METHODS: Twenty-six foxhounds underwent 3 hours of warm ischemia of the left lung, followed by 8 hours of reperfusion. Ischemic pre-conditioning was performed for either 5 minutes (IPC-5) or by 2 10-minute ischemic periods (IPC-10), before ischemia. For endotoxin pre-conditioning, dogs were pre-treated by a daily intravenous application of increasing amounts of endotoxin for 6 days. No pre-conditioning was performed in the controls. Bronchoalveolar lavage was performed before ischemia/reperfusion injury (baseline) and after the 8-hour reperfusion period in the non-injured right and in the reperfused left lung. Bronchoalveolar lavage fluids were analyzed for the phospholipid-protein ratio, the content of large surfactant aggregates, the phospholipid and neutral lipid profile, the surfactant protein (SP) content, and for biophysical activity. RESULTS: Severe surfactant alterations were observed in the ischemia/reperfusion-injured left lung, with increased protein concentrations and depressed concentrations of large surface aggregates, SP-B, dipalmitoylated phosphatidylcholine, and phosphatidylglycerol. Endotoxin pre-conditioning and IPC-5 were both capable of greatly preventing the ischemia/reperfusion injury-related deterioration of surfactant properties. IPC-10 exerted no effects. Endotoxin pre-conditioning and IPC-5, but not IPC-10, also prevented loss of gas exchange. CONCLUSIONS: Ischemic and endotoxin pre-conditioning may protect against impairment of gas exchange in ischemia/reperfusion injury by restoring physiological surfactant properties.
Philipp Markart; Reinhold Schmidt; Clemens Ruppert; Christina Höres; Rolf E Silber; Jochen Börgermann; Andreas Günther; Ivar Friedrich
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  24     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-07     Completed Date:  2006-07-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1680-9     Citation Subset:  IM    
Department of Internal Medicine, Med. Klinik II, Justus-Liebig University, Giessen, Germany.
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MeSH Terms
Bronchoalveolar Lavage Fluid / chemistry
Disease Models, Animal
Endotoxins / administration & dosage*
Escherichia coli
Ischemic Preconditioning*
Lipids / analysis
Lipopolysaccharides / administration & dosage
Lung Diseases / physiopathology,  prevention & control*
Phosphatidylcholines / analysis
Phospholipids / analysis
Pulmonary Gas Exchange
Pulmonary Surfactant-Associated Proteins / analysis*
Reperfusion Injury / physiopathology,  prevention & control*
Reg. No./Substance:
0/Endotoxins; 0/Lipids; 0/Lipopolysaccharides; 0/Phosphatidylcholines; 0/Phospholipids; 0/Pulmonary Surfactant-Associated Proteins

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