Document Detail


Long-acting oral phosphodiesterase inhibition preconditions against reperfusion injury in an experimental lung transplantation model.
MedLine Citation:
PMID:  19379999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Ischemia-reperfusion injury remains a devastating complication of lung transplantation. Phosphodiesterase inhibitors have been shown to precondition tissues against ischemia-reperfusion injury. Little is known, however, about the utility of phosphodiesterase inhibition in reperfusion injury after lung transplantation. We evaluated the long-acting phosphodiesterase-5 inhibitor, tadalafil, in an ex vivo lung transplant model. METHODS: New Zealand White rabbits (4 kg), were given oral tadalafil (n = 11) 24 hours before lung harvest and compared with rabbits given oral vehicle alone (n = 11). Lungs were recovered with Perfadex solution (Vitrolife, Kungsbacka, Sweden) and cold stored for 18 hours. After storage, lung blocks were reperfused with donor rabbit blood in an ex vivo apparatus. Pulmonary artery pressures were recorded with serial arterial and venous blood gas sampling and animals served as their own controls. Phosphodiesterase-5 and protein kinase G tissue activity assays confirmed drug effects. Luminol chemiluminescence assay was used to measure reactive oxygen species and levels of endothelial and inducible nitric oxide synthase were measured. RESULTS: Extended cold storage, followed by reperfusion produced a consistent reproducible decrease in oxygenation and increase in pulmonary pressure. Tadalafil-treated animals exhibited greater Pao(2) throughout the course of reperfusion (P = .001) Mean pulmonary artery pressure was lower in tadalafil-treated animals (22 vs 40 mm Hg; P = .04). Phosphodiesterase-5 activity was decreased (143 +/- 8 vs 205 +/- 32 mP; P < .001) with protein kinase G activity increased (25 +/- 12 vs 12 +/- 2.4 fU/microg; P = .01) in the experimental group confirming that oral pretreatment resulted in active phosphodiesterase inhibition in the lung tissue. Reactive oxygen species (as measured by luminol activity) were decreased in tadalafil-treated animals (7.8 +/- 1.5 vs 10.2 +/- 1.2 relative light units; P = .003). CONCLUSIONS: Our experimental model demonstrates that oral donor pretreatment with a long-acting phosphodiesterase inhibitor is an effective strategy for improving pulmonary performance after reperfusion. Importantly, phosphodiesterase enzymes and their downstream effectors may play a critical role in reperfusion injury after lung transplantation.
Authors:
Eric S Weiss; Hunter C Champion; Jason A Williams; William A Baumgartner; Ashish S Shah
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-03-17
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  137     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-05-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1249-57     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiac Surgery, Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Md. 21287, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Analysis of Variance
Animals
Carbolines / pharmacology*
Cyclic GMP / metabolism
Delayed-Action Preparations / pharmacology
Disease Models, Animal
Graft Rejection
Graft Survival
Immunohistochemistry
Lung Transplantation / adverse effects*,  methods
Phosphodiesterase Inhibitors / pharmacology*
Preoperative Care
Probability
Rabbits
Random Allocation
Reactive Oxygen Species / metabolism
Reference Values
Reperfusion Injury / drug therapy*,  prevention & control
Tissue and Organ Harvesting / methods*
Grant Support
ID/Acronym/Agency:
2T32DK007713-12/DK/NIDDK NIH HHS; P50HL084946/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Carbolines; 0/Delayed-Action Preparations; 0/Phosphodiesterase Inhibitors; 0/Reactive Oxygen Species; 0/tadalafil; 7665-99-8/Cyclic GMP

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


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