Measurements of pulmonary arterial pressure in anesthetized male broilers at two to seven weeks of age

Potential contribution of early endothelial progenitor cell (eEPC)-to-macrophage switching in the development of pulmonary plexogenic lesion

Background

Plexiform lesions, which have a dynamic appearance in structure and cellular composition, are the histological hallmark of severe pulmonary arterial hypertension in humans. The pathogenesis of the lesion development remains largely unknown, although it may be related to local inflammation and dysfunction in early progenitor endothelial cells (eEPCs). We tested the hypothesis that eEPCs contribute to the development of plexiform lesions by differentiating into macrophages in the setting of chronic inflammation.

Methods

The eEPC markers CD133 and VEGFR-2, macrophage lineage marker mannose receptor C-type 1 (MRC1), TNFα and nuclear factor erythroid 2-related factor 2 (Nrf2) in plexiform lesions in a broiler model were determined by immunohistochemistry. eEPCs derived from peripheral blood mononuclear cells were exposed to TNFα, and macrophage differentiation and angiogenic capacity of the cells were evaluated by phagocytotic and Matrigel plug assays, respectively. The role of Nrf2 in eEPC-to-macrophage transition as well as in MRC1 expression was also evaluated. Intratracheal installation of TNFα was conducted to determine the effect of local inflammation on the formation of plexiform lesions.

Results

Cells composed of the early lesions have a typical eEPC phenotype whereas those in more mature lesions display molecular and morphological characteristics of macrophages. Increased TNFα production in plexiform lesions was observed with lesion progression. In vitro studies showed that chronic TNFα challenge directed eEPCs to macrophage differentiation accompanied by hyperactivation of Nrf2, a stress-responsive transcription factor. Nrf2 activation (Keap1 knockdown) caused a marked downregulation in CD133 but upregulation in MRC1 mRNA. Dual luciferase reporter assay demonstrated that Nrf2 binds to the promoter of MRC1 to trigger its expression. In good agreement with the in vitro observation, TNFα exposure induced macrophage differentiation of eEPCs in Matrigel plugs, resulting in reduced neovascularization of the plugs. Intratracheal installation of TNFα resulted in a significant increase in plexiform lesion density.

Conclusions

This work provides evidence suggesting that macrophage differentiation of eEPCs resulting from chronic inflammatory stimulation contributes to the development of plexiform lesions. Given the key role of Nrf2 in the phenotypic switching of eEPCs to macrophages, targeting this molecular might be beneficial for intervention of plexiform lesions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12931-022-02210-7.

Pulse wave velocity and age- and gender-dependent aortic wall hardening in fowl

Before sexual maturation, chickens (Gallus gallus) show high blood pressure (BP) and neointimal plaques in the lower abdominal aortae (AbA). We investigated age/sex-related changes in pulse wave velocity (PWV), elastin, collagen, and protein levels in AbA, and cardiac morphology to determine whether PWV increases during incremental increases in BP of maturing fowl, while arterial stiffness becomes dominant with aging. PWV (m/s) was significantly greater in male chicks (6-7 weeks, 9.3+/-0.8; females, 6.1+/-0.5) and remained high in cockerels (13 weeks), young (27-28 weeks), and adults (44-66 weeks). PWV increased in prepubertal pullets (10.0+/-0.9), dropped significantly in young hens, and remained low in adults. In contrast, medial thickness, protein levels, and collagen levels increased, while elastin/collagen ratios decreased, with maturation/aging. Males had heavier ventricular mass and thicker ventricular walls than females at all ages; left ventricular thickness decreased with maturation/aging. Thus, sustained high BP may have caused progressive medial hypertrophy, increased aortic rigidity, and enlarged hearts with left ventricular dilation. PWV of AbA was already greater in male chicks at an age when both sexes have similar collagen levels and low protein levels, suggesting that a factor other than structural stiffness may be an important determinant of PWV.

Broiler pulmonary hypertensive responses during lipopolysaccharide-induced tolerance and cyclooxygenase inhibition

Bacterial lipopolysaccharide (LPS, endotoxin) triggers pulmonary hypertension (PH) characterized by an increase in pulmonary arterial pressure (PAP) that reaches a peak value within 20 to 25 min and then gradually subsides within 60 min. As the PAP subsides PH cannot be reinitiated, signifying the onset of a period of tolerance (refractoriness) to repeated LPS exposure. The present study was conducted to determine the duration of this tolerance, and to evaluate key mediators thought to contribute to LPS-mediated PH in broilers. Tolerance was shown to persist for 4 to 5 d after the initial exposure to LPS. In tolerant broilers supramaximal i.v. injections of LPS did not reinitiate PH, nor was a significant modulatory role for nitric oxide demonstrated. The pulmonary vasculature of tolerant broilers remains responsive to the thromboxane A(2) (TxA(2)) mimetic U44069, 5-hydroxytryptamine (5-HT, serotonin), and constitutive nitric oxide. Meclofenamate successfully blocked the conversion of arachidonic acid to vasoconstrictive eicosanoids such as TxA(2); nevertheless, meclofenamate failed to inhibit PH in response to LPS. Therefore, TxA(2) does not appear to be the primary vasoconstrictor involved in the PH response to LPS and neither does 5-HT. Broilers emerging from tolerance 5 d after the initial exposure to LPS exhibited interindividual variation in their PH responsiveness to a second LPS injection, ranging from zero response (individuals that remain fully tolerant) to large increases in PAP (post-tolerant individuals). Tolerance might be an important compensatory or protective mechanism for broilers whose pulmonary vascular capacity is marginally adequate under optimal conditions, and whose respiratory systems are chronically challenged with LPS in commercial production facilities. The key vasoconstrictors responsible for the PH elicited by LPS remain to be determined.

Echocardiographic characteristics of chickens with ascites syndrome

1. B- and M-mode echocardiography was used to compare cardiac function in broilers with spontaneous ascites syndrome with that of normal chickens. 2. Thirty ascitic chickens and 15 normal chickens aged three, 4, 5, and 6 weeks from the same flock (180 birds in total) were examined. They were restrained gently in a natural standing position, and echocardiographs were obtained from a 7.0-MHz linear transducer placed on the left pectoral apterium. Indices of cardiac structure and functioning were calculated from the echocardiographs, and some were normalised to body weight. Heart rate was also measured. 3. All cardiac structural indices in both ascitic and normal chickens increased with age. Compared with normal chickens, right ventricular diameter at the end of systole in ascitic chickens was greater at 4, 5 and 6 weeks of age. Ventricular septal thickness at the end of both systole and diastole was greater in ascitic chickens at 5 and 6 weeks. Left ventricular free wall thickness at the end of diastole was less in ascitic chickens at 3 weeks. However, all the structural indices decreased with age after normalisation with body weight. 4. The heart rate of ascitic chickens was lower at 4, 5 and 6 weeks. Normalised left ventricular fractional shortening was lower in ascitic chickens at 4, 5 and 6 weeks, as was normalised right ventricular fractional shortening. Incrassation of the ventricular septum (Delta T), which changed little in normal chickens, was less at 4, 5 and 6 weeks in ascitic chickens. Left ventricular fractional shortening, right ventricular fractional shortening and Delta T were all negatively correlated with ascites heart index at all ages. 5. Taken together the results suggest heart failure of both ventricle, but that right ventricular dysfunction is more extensive than left ventricular dysfunction. We suggest that secondary pulmonary hypertension would result in these ascitic chickens due to volume overload.

Nω-Nitro-L-Arginine Methyl Ester (L-NAME) Amplifies the Pulmonary Hypertensive Response to Endotoxin in Broilers

The pulmonary hypertensive response to bacterial lipopolysaccharide (LPS, endotoxin) varies widely among individual broilers, leading to the suggestion that innate variability may exist in the proportions or profiles of chemical mediators released during the ensuing inflammatory cascade. LPS induces the expression of nitric oxide synthase (iNOS), which produces the vasodilator nitric oxide (NO) to modulate the responses to concurrently produced vasoconstrictors. In experiment 1, broilers were given the NOS inhibitor N(omega)-nitro-L-arginine methyl ester (L-NAME), followed by a supra-maximal dose of LPS while the pulmonary arterial pressure was recorded. In experiment 2 the cardiac output also was recorded before and following the i.v. injection of L-NAME. In both experiments, injection with L-NAME modestly increased the pulmonary arterial pressure when compared with control values, confirming previous reports that tonic/basal NO synthesis is required to promote flow-dependent pulmonary vasodilation in chickens. This response to L-NAME occurred in spite of a tendency for cardiac output and stroke volume to decline and, therefore, can be attributed to pulmonary vasoconstriction (an increase in the pulmonary vascular resistance) rather than an increase in pulmonary blood flow. When L-NAME was used to block NO synthesis induced by LPS, an early peak of pulmonary hypertension was revealed that rarely develops in broilers in the absence of L-NAME, and that has been correlated with the release of platelet activating factor and thromboxane A2 in mammals. The control group responded to LPS with a delayed-onset pulmonary hypertension that was typical in timing, amplitude, and duration of the responses previously observed in broilers and that has been attributed to endothelin-mediated thromboxane A2 synthesis in mammals. This delayed-onset pulmonary hypertensive response to LPS was longer in duration and higher in amplitude in the L-NAME group when compared with the control group. These observations are consistent with the hypothesis that NO modulates the responses to vasoconstrictors released concurrently during the LPS-mediated inflammatory cascade. Inhibition of NOS by L-NAME apparently reduced the modulatory influence of NO and exposed a more dramatic pulmonary hypertensive response to LPS.

Effect of cage vs. floor litter environments on the pulmonary hypertensive response to intravenous endotoxin and on blood-gas values in broilers

Intravenous endotoxin has been shown to trigger a delayed pulmonary hypertensive response that varies widely in magnitude and duration among individual broilers. It was proposed that this individual variability may reflect immunological differences acquired during previous respiratory challenges that might have subsequently altered the endotoxin-initiated biochemical cascade. In Experiment 1, we tested the hypothesis that, when compared with broilers reared in clean stainless steel cages (Cage group), broilers reared on floor litter (Floor group) should experience a greater respiratory challenge and therefore may consistently exhibit a more enhanced pulmonary hypertensive response to intravenous endotoxin. Birds in the Cage group were grown in stainless steel cages at a low density (72 birds/8 m2 chamber), and fecal and dander materials were removed daily. Birds in the Floor group were reared on wood-shavings litter at a higher density (110 birds/8 m2 chamber). Pulmonary and systemic mean arterial pressures and blood-gas values were evaluated prior to and following the intravenous administration of 1 mg Salmonella typhimurium endotoxin. Broilers in the Floor and Cage groups exhibited pulmonary hypertensive responses to endotoxin that were very similar in terms of time of onset, duration, and magnitude, as well as variability in the response among individuals. Systemic hypotension also developed similarly in both groups following endotoxin injection. Blood-gas values indicated that the partial pressure of CO2 and the HCO3- concentration in arterial blood were higher (P < 0.05) in the Floor group than in the Cage group prior to and subsequent to the endotoxin injection. In Experiment 2, we reevaluated the effect of a dirty vs. a clean environment on blood-gas values using a different strain of broilers, and confirmed the negative impact of floor rearing on blood-gas values. We conclude that broilers reared on the floor inhaled litter dust and noxious fumes, which impaired pulmonary gas exchange and increased the arterial partial pressure of CO2 when compared with broilers reared in clean stainless steel cages. Nevertheless, the pulmonary hypertensive response to endotoxin did not differ between broilers reared on the floor and those in cages.

Pulmonary hypertensive response to endotoxin in cellulose-primed and unprimed broiler chickens

Previous studies indicate that individual broilers vary widely in their pulmonary vascular responsiveness to i.v. injections of endotoxin. This individual variability may reflect differences acquired during previous respiratory challenges or genetic variability that may be associated with susceptibility to pulmonary hypertension syndrome (ascites). In the present study, we compared the endotoxin responses of 4- to 5- wk-old control broilers (unprimed) and broilers in which the pulmonary vasculature had been immunologically challenged 48 h previously by an i.v. injection of cellulose micro-particles (primed). The injected cellulose micro-particles are carried in the venous blood to the lungs, where they become trapped in the pulmonary vasculature and initiate acute focal inflammatory responses within the surrounding lung parenchyma. Physiological variables (respiratory rate, heart rate, pulmonary and systemic arterial pressures) were evaluated prior to and following the i.v. administration of 1 mg of Salmonella typhimurium endotoxin. Prior to endotoxin injection, the respiratory rate was higher in primed than in unprimed broilers; however, the heart rate, pulmonary arterial pressure, and systemic arterial pressure did not differ between groups. Broilers in both groups exhibited similar ranges of individual variability in their endotoxin responses. The overall time of onset, magnitude, and duration of the pulmonary hypertensive responses were similar for both groups. Accordingly, the initiation of a preexisting inflammatory response within the lung parenchyma did not alter the timing, amplitude, or variability of the subsequent pulmonary hypertensive response to endotoxin in broilers.

Intravenous micro-particle injection and pulmonary hypertension in broiler chickens: cardio-pulmonary hemodynamic responses

Experiments were conducted to determine whether intravenous injections of micro-particles, having a size suitable to be trapped by the pulmonary precapillary arterioles, could be used to increase the pulmonary vascular resistance and thereby trigger an acute increase in the pulmonary arterial pressure (pulmonary hypertension). Anesthetized male broilers injected intravenously with inorganic (silica gel, polystyrene) or organic (cellulose, Sephadex) micro-particles developed an immediate pulmonary hypertension in proportion to the cumulative quantities of micro-particles injected. Micro-particle occlusion of a portion of the pulmonary arterioles forced the cardiac output to flow at a higher rate through the remaining vascular channels, thereby exposing a diffusion limitation characterized by undersaturation of the systemic arterial blood with oxygen (hypoxemia). The concurrent onset of systemic hypotension (reduced systemic arterial blood pressure) was not due to a reduction in cardiac output but rather was attributed to hypoxemic vasodilation of the systemic vasculature (reduced total peripheral resistance). Preliminary histological evaluations revealed micro-particles lodged in inter- and intraparabronchial arterioles, surrounded by aggregates of thrombocytes and mononuclear leukocytes within 30 min post-injection. These observations infer that intravenously injected micro-particles are carried to the lungs by the returning venous blood, where trapping of the micro-particles by the pulmonary vasculature triggers acute responses (increased pulmonary vascular resistance, pulmonary hypertension, systemic hypoxemia, systemic hypotension) that mirror those previously observed following acute occlusion of one pulmonary artery. Additional studies will be required to determine the extent to which the focal immune response to trapped micro-particles promotes local vasoconstriction that amplifies the pulmonary hypertension attributable to direct physical obstruction of precapillary arterioles.

Pulmonary arterial pressure and electrocardiograms in broiler chickens infused intravenously with L-NAME, an inhibitor of nitric oxide synthase, or sodium nitroprusside (SNP), a nitric oxide donor

1. Broilers were divided at 42 to 44 d of age into a Control group (n=30) and a Treatment group (n=30). The mean pulmonary arterial pressure (mPAP) and electrocardiogram (ECG) leads II and aV(F) were measured 1, 2 and 4 h after an intravenous injection of 0.9% saline (Control group) or Nomega-nitro-L-arginine methyl esther (L-NAME), an inhibitor of nitric oxide synthase and thus an inhibitor of endothelial nitric oxide (NO) production (Treatment group). 2. At 1 and 2 h but not 4 h post-injection, L-NAME significantly increased the mPAP and the amplitudes of the ECG S-wave and RS-wave leads II and aVF when compared with Control values. 3. The correlation coefficients between the mPAP and the ECG S-wave and RS-wave amplitudes for lead II within the Treatment group were -0.848 and -0.553 at 1 h and -0.798 and -0.512 at 2 h, respectively. The corresponding coefficients for lead aVF were -0.735, -0.596, -0.663 and -0.724, respectively. 4. After suitable mPAP and ECG values had been recorded at each time interval, sodium nitroprusside (SNP), which acts as a short-lived NO donor molecule, was injected intravenously via a right-cardiac catheter. Within 5 min after the SNP injection, the mPAP and the ECG lead II S-wave and RS-wave amplitudes were transiently reduced to levels that, at 1 and 2 h after L-NAME injection, did not differ from Control values. Within 10 min after the SNP injection, all values returned to the levels previously induced by L-NAME. 5. These results demonstrate that L-NAME increased the myocardial contractility and PAP, whereas SNP transiently reversed the effects of L-NAME on myocardial contractility and PAP. It appears likely from these results that the pulmonary vascular endothelium releases NO that in turn reduces the pulmonary vascular resistance or attenuates myocardial contractility in broiler chickens.

Furosemide does not facilitate pulmonary vasodilation in broilers during chronic or acute unilateral pulmonary arterial occlusion

Furosemide (FURO) is a diuretic and a putative pulmonary vasodilator that, when added to broiler diets, previously has been shown to reduce the cumulative pulmonary hypertension syndrome (PHS) mortality induced by cold temperatures. The objective of the present study was to evaluate the influence of dietary FURO on the pulmonary vasculature in broilers undergoing chronic or acute unilateral pulmonary arterial occlusion. Broilers were fed a standard ration throughout the entire experiment (Control group) or the same ration supplemented with 0.015% (wt/wt) FURO from Day 14 to 42 (FURO group). In the present study chicks were chosen at random at 16 to 18 d of age to undergo sham surgery or a chronic unilateral pulmonary artery clamp (PAC) procedure. Diet and surgical treatments resulted in Control-Sham, FURO-Sham, Control-PAC, and FURO-PAC groups. The Control-PAC and FURO-PAC groups did not differ in body weight or right:total ventricular weight ratios (RV:TV). The postsurgical mortality, ascites mortality, and mortality due to other causes did not differ between the Control-PAC and FURO-PAC groups. Plasma Na+ (P < or = 0.05) was lower in the FURO-Sham group than in the Control-Sham group. Broilers from the same hatch were fed Control or FURO diets and surgically prepared for acute unilateral pulmonary arterial occlusion by using a snare. Tightening of the snare triggered characteristic increases in pulmonary blood flow, pulmonary arterial pressure, and pulmonary vascular resistance. Across all of these variables, the Control and FURO groups did not differ during any sample interval. Dietary FURO did not affect body weight, hematocrit, or RV:TV. Dietary FURO at 0.015% (wt/wt) does not appear to influence the pulmonary vasculature in broilers, but it may prolong the survival of broilers during the pathophysiological progression of PHS.