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Dugbartey GJ. Carbon monoxide as an emerging pharmacological tool to improve lung and liver transplantation protocols. Biochem Pharmacol 2021; 193:114752. [PMID: 34487717 DOI: 10.1016/j.bcp.2021.114752] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/16/2022]
Abstract
Carbon monoxide (CO) has long been considered purely as a toxic gas. It binds to hemoglobin at high concentrations and displaces oxygen from its binding site, resulting in carboxyhemoglobin formation, which reduces oxygen-carrying capacity of blood and culminates in tissue hypoxia and its associated complications. Recently, however, CO is quickly moving past its historic notorious tag as a poisonous gas to a physiological signaling molecule with therapeutic potentials in several clinical situations including transplant-induced injury. This review discusses current knowledge of CO gas and CO-releasing molecules (CO-RMs) in preclinical models of lung and liver transplantation, and underlying molecular mechanisms of cyto- and organ protection during organ procurement, preservation, implantation and post-transplant periods. In addition, a discussion of the future of CO in clinical organ transplantation is provided.
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Affiliation(s)
- George J Dugbartey
- Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada; Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, Western University, London Health Sciences Center, Western University, London, Ontario, Canada; Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
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Wong A, Liu M. Inflammatory responses in lungs from donation after brain death: Mechanisms and potential therapeutic targets. J Heart Lung Transplant 2021; 40:890-896. [PMID: 34167864 DOI: 10.1016/j.healun.2021.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 01/16/2023] Open
Abstract
The vast majority of lungs used in clinical transplantation are donated after brain death (DBD). The utilization of DBD lungs is low due to brain death-induced lung injury. Moreover, inflammatory responses in DBD lungs used for transplantation contribute to ischemia-reperfusion injury and primary graft dysfunction. Work from human observational studies has demonstrated overexpression of cytokines, activation of endothelial cells, and cell death in DBD lungs, are associated with the activation of signaling pathways. Animal models have characterized the pulmonary injury induced by brain death and identified potential strategies to improve donor management. Interestingly, transcriptomic studies comparing DBD and donated after circulatory death (DCD) lungs have found that inflammatory responses are elevated in DBD lungs, while cell death pathways are elevated in DCD lungs. Development of the ex vivo lung perfusion technique, has made it possible to assess donor lungs using inflammation and cell death biomarkers. In the future, identification of potential therapeutic targets and development of novel treatments strategies may allow for lung repair during EVLP prior to transplantation.
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Affiliation(s)
- Aaron Wong
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada. https://twitter.com/aaronkkwong
| | - Mingyao Liu
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Latner Thoracic Surgical Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada; Departments of Surgery, Medicine and Physiology, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada.
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Cipolla MJ, Linfante I, Abuchowski A, Jubin R, Chan SL. Pharmacologically increasing collateral perfusion during acute stroke using a carboxyhemoglobin gas transfer agent (Sanguinate™) in spontaneously hypertensive rats. J Cereb Blood Flow Metab 2018; 38:755-766. [PMID: 28436705 PMCID: PMC5987934 DOI: 10.1177/0271678x17705567] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Similar to patients with chronic hypertension, spontaneously hypertensive rats (SHR) develop fast core progression during middle cerebral artery occlusion (MCAO) resulting in large final infarct volumes. We investigated the effect of Sanguinate™ (SG), a PEGylated carboxyhemoglobin (COHb) gas transfer agent, on changes in collateral and reperfusion cerebral blood flow and brain injury in SHR during 2 h of MCAO. SG (8 mL/kg) or vehicle ( n = 6-8/group) was infused i.v. after 30 or 90 min of ischemia with 2 h reperfusion. Multi-site laser Doppler probes simultaneously measured changes in core MCA and collateral flow during ischemia and reperfusion using a validated method. Brain injury was measured using TTC. Animals were anesthetized with choral hydrate. Collateral flow changed little in vehicle-treated SHR during ischemia (-8 ± 9% vs. prior to infusion) whereas flow increased in SG-treated animals (29 ± 10%; p < 0.05). In addition, SG improved reperfusion regardless of time of treatment; however, brain injury was smaller only with early treatment in SHR vs. vehicle (28.8 ± 3.2% vs. 18.8 ± 2.3%; p < 0.05). Limited collateral flow in SHR during MCAO is consistent with small penumbra and large infarction. The ability to increase collateral flow in SHR with SG suggests that this compound may be useful as an adjunct to endovascular therapy and extend the time window for treatment.
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Affiliation(s)
- Marilyn J Cipolla
- 1 Department of Neurological Sciences and Pharmacology, University of Vermont College of Medicine, Burlington, VT, USA
| | - Italo Linfante
- 2 Miami Cardiac and Vascular Institute and Neuroscience Center, Baptist Hospital, Miami, FL, USA
| | - Abe Abuchowski
- 3 Prolong Pharmaceuticals, LLC, South Plainfield, NJ, USA
| | - Ronald Jubin
- 3 Prolong Pharmaceuticals, LLC, South Plainfield, NJ, USA
| | - Siu-Lung Chan
- 1 Department of Neurological Sciences and Pharmacology, University of Vermont College of Medicine, Burlington, VT, USA
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Maignan M, Gennai S, Debaty G, Romanini D, Schmidt MH, Brenckmann V, Brouta A, Ventrillard I, Briot R. Exhaled carbon monoxide is correlated with ischemia reperfusion injuries during
ex vivo
lung perfusion in pigs. J Breath Res 2017. [DOI: 10.1088/1752-7163/aa7a73] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Meng C, Ma L, Niu L, Cui X, Liu J, Kang J, Liu R, Xing J, Jiang C, Zhou H. Protection of donor lung inflation in the setting of cold ischemia against ischemia-reperfusion injury with carbon monoxide, hydrogen, or both in rats. Life Sci 2016; 151:199-206. [PMID: 26969763 DOI: 10.1016/j.lfs.2016.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 03/05/2016] [Accepted: 03/08/2016] [Indexed: 12/25/2022]
Abstract
AIMS Lung ischemia-reperfusion injury (IRI) may be attenuated through carbon monoxide (CO)'s anti-inflammatory effect or hydrogen (H2)'s anti-oxidant effect. In this study, the effects of lung inflation with CO, H2, or both during the cold ischemia phase on graft function were observed. MATERIALS AND METHODS Rat donor lungs, inflated with 40% oxygen (control group), 500ppm CO (CO group), 3% H2 (H2 group) or 500ppm CO+3% H2 (COH group), were kept at 4°C for 180min. After transplantation, the recipients' artery blood gas and pressure-volume (P-V) curves were analyzed. The inflammatory response, oxidative stress and apoptosis in the recipients were assessed at 180min after reperfusion. KEY FINDINGS Oxygenation in the CO and H2 groups were improved compared with the control group. The CO and H2 groups also exhibited significantly improved P-V curves, reduced lung injury, and decreased inflammatory response, malonaldehyde content, and cell apoptosis in the grafts. Furthermore, the COH group experienced enhanced improvements in oxygenation, P-V curves, inflammatory response, lipid peroxidation, and graft apoptosis compared to the CO and H2 groups. SIGNIFICANCE Lung inflation with CO or H2 protected against IRI via anti-inflammatory, anti-oxidant and anti-apoptotic mechanisms in a model of lung transplantation in rats, which was enhanced by combined treatment with CO and H2.
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Affiliation(s)
- Chao Meng
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China; The Hei Longjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, Hei Longjiang Province 150001, China
| | - Liangjuan Ma
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China
| | - Li Niu
- Department of Anesthesiology, The 211 Hospital of the Chinese People's Liberation Army, Harbin, Hei Longjiang Province 150001, China
| | - Xiaoguang Cui
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China; The Hei Longjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, Hei Longjiang Province 150001, China
| | - Jinfeng Liu
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China; The Hei Longjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, Hei Longjiang Province 150001, China
| | - Jiyu Kang
- Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China
| | - Rongfang Liu
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China; The Hei Longjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, Hei Longjiang Province 150001, China
| | - Jingchun Xing
- Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China; The Hei Longjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, Hei Longjiang Province 150001, China
| | - Changlin Jiang
- Department of Anesthesiology, The General Hospital of Daqing Oilfield, Daqing, Hei Longjiang Province 163000, China
| | - Huacheng Zhou
- Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Hei Longjiang Province 150001, China.
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Simas R, Ferreira SG, Menegat L, Zanoni FL, Correia CJ, Silva IA, Sannomiya P, Moreira LFP. Mesenteric hypoperfusion and inflammation induced by brain death are not affected by inhibition of the autonomic storm in rats. Clinics (Sao Paulo) 2015; 70:446-52. [PMID: 26106965 PMCID: PMC4462575 DOI: 10.6061/clinics/2015(06)11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/31/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Brain death is typically followed by autonomic changes that lead to hemodynamic instability, which is likely associated with microcirculatory dysfunction and inflammation. We evaluated the role of the microcirculation in the hemodynamic and inflammatory events that occur after brain death and the effects of autonomic storm inhibition via thoracic epidural blockade on mesenteric microcirculatory changes and inflammatory responses. METHODS Male Wistar rats were anesthetized and mechanically ventilated. Brain death was induced via intracranial balloon inflation. Bupivacaine (brain death-thoracic epidural blockade group) or saline (brain death group) infusion via an epidural catheter was initiated immediately before brain death induction. Sham-operated animals were used as controls (SH group). The mesenteric microcirculation was analyzed via intravital microscopy, and the expression of adhesion molecules was evaluated via immunohistochemistry 180 min after brain death induction. RESULTS A significant difference in mean arterial pressure behavior was observed between the brain death-thoracic epidural blockade group and the other groups, indicating that the former group experienced autonomic storm inhibition. However, the proportion of perfused small vessels in the brain death-thoracic epidural blockade group was similar to or lower than that in the brain death and SH groups, respectively. The expression of intercellular adhesion molecule 1 was similar between the brain death-thoracic epidural blockade and brain death groups but was significantly lower in the SH group than in the other two groups. The number of migrating leukocytes in the perivascular tissue followed the same trend for all groups. CONCLUSIONS Although thoracic epidural blockade effectively inhibited the autonomic storm, it did not affect mesenteric hypoperfusion or inflammation induced by brain death.
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Araujo LFL, Holand ARR, Paludo ADO, Silva ÉF, Forgiarini LA, Forgiarini LF, Barbachan E Silva M, Andrade CF. Effect of the systemic administration of methylprednisolone on the lungs of brain-dead donor rats undergoing pulmonary transplantation. Clinics (Sao Paulo) 2014; 69:128-33. [PMID: 24519204 PMCID: PMC3912341 DOI: 10.6061/clinics/2014(02)09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 08/14/2013] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Most lung transplants are obtained from brain-dead donors. The physiopathology of brain death involves hemodynamics, the sympathetic nervous system, and inflammatory mechanisms. Administering methylprednisolone 60 min after inducing brain death in rats has been shown to modulate pulmonary inflammatory activity. Our objective was to evaluate the effects of methylprednisolone on transplanted rat lungs from donors treated 60 min after brain death. METHODS Twelve Wistar rats were anesthetized, and brain death was induced. They were randomly divided into two groups (n=6), namely a control group, which was administered saline solution, and a methylprednisolone group, which received the drug 60 min after the induction of brain death. All of the animals were observed and ventilated for 2 h prior to being submitted to lung transplantation. We evaluated the hemodynamic and blood gas parameters, histological score, lung tissue levels of thiobarbituric acid-reactive substances, level of superoxide dismutase, level of tumor necrosis factor-alpha, and level of interleukin-1 beta. RESULTS After transplantation, a significant reduction in the levels of tumor necrosis factor-alpha and IL-1β was observed in the group that received methylprednisolone (p=0.0084 and p=0.0155, respectively). There were no significant differences in tumor necrosis factor-alpha and superoxide dismutase levels between the control and methylprednisolone groups (p=0.2644 and p=0.7461, respectively). There were no significant differences in the blood gas parameters, hemodynamics, and histological alterations between the groups. CONCLUSION The administration of methylprednisolone after brain death in donor rats reduces inflammatory activity in transplanted lungs but has no influence on parameters related to oxidative stress.
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Affiliation(s)
- Luiz Felipe Lopes Araujo
- Federal University of Rio Grande do Sul, Postgraduate Program in Pulmonary Sciences, Porto AlegreRS, Brazil, Federal University of Rio Grande do Sul (UFRGS), Postgraduate Program in Pulmonary Sciences, Porto Alegre/RS, Brazil
| | - Arthur Rodrigo Ronconi Holand
- Hospital de Clínicas de Porto Alegre, Lung and Airway Laboratory, Porto AlegreRS, Brazil, Hospital de Clínicas de Porto Alegre (HCPA), Lung and Airway Laboratory, Porto Alegre/RS, Brazil
| | - Artur de Oliveira Paludo
- Hospital de Clínicas de Porto Alegre, Lung and Airway Laboratory, Porto AlegreRS, Brazil, Hospital de Clínicas de Porto Alegre (HCPA), Lung and Airway Laboratory, Porto Alegre/RS, Brazil
| | - Éverton Franco Silva
- Hospital de Clínicas de Porto Alegre, Lung and Airway Laboratory, Porto AlegreRS, Brazil, Hospital de Clínicas de Porto Alegre (HCPA), Lung and Airway Laboratory, Porto Alegre/RS, Brazil
| | - Luiz Alberto Forgiarini
- Hospital de Clínicas de Porto Alegre, Lung and Airway Laboratory, Porto AlegreRS, Brazil, Hospital de Clínicas de Porto Alegre (HCPA), Lung and Airway Laboratory, Porto Alegre/RS, Brazil
| | - Luiz Felipe Forgiarini
- Hospital de Clínicas de Porto Alegre, Lung and Airway Laboratory, Porto AlegreRS, Brazil, Hospital de Clínicas de Porto Alegre (HCPA), Lung and Airway Laboratory, Porto Alegre/RS, Brazil
| | - Mariel Barbachan E Silva
- Hospital de Clínicas de Porto Alegre, Lung and Airway Laboratory, Porto AlegreRS, Brazil, Hospital de Clínicas de Porto Alegre (HCPA), Lung and Airway Laboratory, Porto Alegre/RS, Brazil
| | - Cristiano Feijó Andrade
- Federal University of Rio Grande do Sul, Postgraduate Program in Pulmonary Sciences, Porto AlegreRS, Brazil, Federal University of Rio Grande do Sul (UFRGS), Postgraduate Program in Pulmonary Sciences, Porto Alegre/RS, Brazil
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Zhou H, Fu Z, Wei Y, Liu J, Cui X, Yang W, Ding W, Pan P, Li W. Hydrogen inhalation decreases lung graft injury in brain-dead donor rats. J Heart Lung Transplant 2013; 32:251-8. [DOI: 10.1016/j.healun.2012.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 11/01/2012] [Accepted: 11/10/2012] [Indexed: 11/29/2022] Open
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Silva I, Correia C, Simas R, Correia C, Cruz J, Ferreira S, Zanoni F, Menegat L, Sannomiya P, Moreira L. Inhibition of Autonomic Storm by Epidural Anesthesia Does Not Influence Cardiac Inflammatory Response After Brain Death in Rats. Transplant Proc 2012; 44:2213-8. [DOI: 10.1016/j.transproceed.2012.07.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Caumartin Y, Stephen J, Deng JP, Lian D, Lan Z, Liu W, Garcia B, Jevnikar AM, Wang H, Cepinskas G, Luke PP. Carbon monoxide-releasing molecules protect against ischemia–reperfusion injury during kidney transplantation. Kidney Int 2011; 79:1080-9. [DOI: 10.1038/ki.2010.542] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Zhou H, Qian H, Liu J, Zhu D, Ding W, Pan P, Jin D, Wang J, Li W. Protection against lung graft injury from brain-dead donors with carbon monoxide, biliverdin, or both. J Heart Lung Transplant 2011; 30:460-6. [PMID: 21216159 DOI: 10.1016/j.healun.2010.11.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 10/01/2010] [Accepted: 11/14/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The process of brain death can induce acute lung injury in donors and aggravate ischemia-reperfusion injury in grafts. Carbon monoxide (CO) and biliverdin (BV) have been shown to attenuate ischemia-reperfusion injury. We therefore examined if the administration of both CO and BV provide enhanced cytoprotection against lung graft injury from brain-dead (BD) rat donors. METHODS Brain death was induced in all donors, after which they were observed for 1.5 hours and then underwent lung transplantation. The recipients were ventilated with 40% oxygen (control group), ventilated with 250 ppm CO in 40% oxygen (CO group), treated with BV (35 mg/kg) intraperitoneally (BV group), or treated with CO and BV conjointly (COBV group) before transplantation (n = 8 each group). The recipients were sacrificed 2 hours after lung transplantation by exsanguination. Serum levels of interleukin (IL)-8 and tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay. RESULTS CO and/or BV treatment attenuated partial pressure of arterial oxygen (Pao(2))/fraction of inspired oxygen (Fio(2)) aggravation in the recipients after reperfusion, reduced the wet weight/dry weight ratio, decreased the lung injury score, inhibited the activity of myeloperoxidase in grafts, and decreased serum levels of IL-8 and TNF-α compared with the control group (p < 0.05). The COBV group had significantly decreased malonaldehyde levels and increased superoxide dismutase levels in lung grafts compared with the CO group (p < 0.05). The static pressure-volume curve of the lungs was ameliorated in the CO group, BV group, and COBV group compared with the control group (p < 0.05). CONCLUSIONS CO and BV exert protective effects through anti-inflammatory and anti-oxidant mechanisms, and dual treatment provided enhanced cytoprotection against lung graft injury from BD rat donors.
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Affiliation(s)
- Huacheng Zhou
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University, and Hei Long Jiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Harbin, China
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Exogenous biliverdin improves the function of lung grafts from brain dead donors in rats. Transplant Proc 2010; 42:1602-9. [PMID: 20620483 DOI: 10.1016/j.transproceed.2010.01.076] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/29/2009] [Accepted: 01/07/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND Biliverdin, a product of heme oxygenase-1 (HO-1), ameliorates the posttransplant functions of heart, kidney, and liver. In this study, we investigated the effects of biliverdin on lung grafts from brain dead (BD) rat donors. METHODS Male Wistar rats were randomly divided into 3 groups. The sham group (n = 7), did not undergo BD. Both donor and recipient rats in the BD biliverdin group (n = 8) were injected with biliverdin (35 mg/kg in 1 mL) intraperitoneally after confirmed BD and transplantation. In the BD group (n = 8), both donor and recipient rats received the same volume of saline (35 mg/kg in 1 mL) as the BD biliverdin group. All donor rats were observed for 1.5 hours before undergoing lung transplantation. Two hours after transplantation, we obtained blood and lung graft samples. RESULTS Biliverdin reversed the aggravation of Pa(O(2)) in recipients, reduced the grafts wet/dry ratio, decreased the severity of lung injury measured by histologic examination, reduced serum tumor necrosis factor-alpha and interleukin-8 levels and inhibited myeloperoxidase activity (MPO) in the grafts. Furthermore, it significantly decreased malonaldehyde levels and increased superoxide dismutase levels. Biliverdin reduced cell apoptosis, activated protein expression of biliverdin reductase, and inhibited expression of HO-1 and nuclear factor (NF)-kappaB in lung grafts. CONCLUSION Biliverdin exerts protective effects on lung grafts from BD donors through anti-inflammatory, antioxidant, and anti-apoptotic mechanisms.
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Zhou H, Liu J, Pan P, Jin D, Ding W, Li W. Carbon monoxide inhalation decreased lung injury via anti-inflammatory and anti-apoptotic effects in brain death rats. Exp Biol Med (Maywood) 2010; 235:1236-43. [PMID: 20810760 DOI: 10.1258/ebm.2010.010147] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Brain death (BD) induces acute lung injury and makes donor lungs unfit for transplantation. Carbon monoxide (CO) inhalation at 50–500 ppm exerts anti-inflammatory and anti-apoptosis effects in several lung injury models. We examined whether CO inhalation would show favorable effects on lung injury in BD rats. BD rats inhaled 250 ppm CO for two hours. Inhalation decreased the severity of lung injury, as checked by histological examination. CO treatment reversed aggravation in PaO2/FiO2, base excess and pH of BD rats. CO inhalation downregulated the pro-inflammatory cytokines (tumor necrosis factor- α, interleukin-6), and inhibited activity of myeloperoxidase in lung tissue. Inhalation significantly decreased cell apoptosis of lungs, and inhibited mRNA expression of intercellular adhesion molecule-1 and caspase-3 in the lungs. Further, the inhalation activated phosphorylation of p38 expression and inhibited phosphorylation of extracellular signal-regulated kinase expression in the lungs. In conclusion, CO exerts potent protective effects on lungs from BD rats, exhibiting anti-inflammatory and anti-apoptosis functions by modulating the mitogen-activated protein kinase signal transduction.
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Affiliation(s)
- Huacheng Zhou
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University
- Hei Long Jiang Province Key Laboratory of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Jinfeng Liu
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University
- Hei Long Jiang Province Key Laboratory of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Peng Pan
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University
- Hei Long Jiang Province Key Laboratory of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Di Jin
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University
- Hei Long Jiang Province Key Laboratory of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Wengang Ding
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University
- Hei Long Jiang Province Key Laboratory of Research on Anesthesiology and Critical Care Medicine, Harbin, China
| | - Wenzhi Li
- Department of Anesthesiology, The Second Affiliated Hospital, Harbin Medical University
- Hei Long Jiang Province Key Laboratory of Research on Anesthesiology and Critical Care Medicine, Harbin, China
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Ghosh S, Gal J, Marczin N. Carbon monoxide: endogenous mediator, potential diagnostic and therapeutic target. Ann Med 2010; 42:1-12. [PMID: 20092397 DOI: 10.3109/07853890903482877] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The primary objectives of this article are to review the potential role of carbon monoxide (CO) as an endogenous mediator, diagnostic marker for pulmonary disorders, and therapeutic target in critical illness. The review will start by focusing on the importance of the heme oxygenase (HO)-CO axis as an endogenous system as it relates to the cardiovascular and pulmonary systems. It will elucidate the influence of HO gene expression on critical events like shock, sepsis, ischemia-reperfusion and others. Our focus will then shift and look at the potential diagnostic role of exhaled CO in major inflammatory states of the lung, and finally we will highlight the activities on inhaled CO being considered as a possible therapeutic tool and the controversies surrounding it.
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Affiliation(s)
- Subhamay Ghosh
- Department of Anaesthesiology and Intensive Therapy, University of Pecs, 7624 Pecs, Hungary.
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Oto T, Calderone A, Li Z, Rosenfeldt FL, Pepe S. p38 Mitogen-activated protein kinase inhibition reduces inflammatory cytokines in a brain-dead transplant donor animal model. Heart Lung Circ 2009; 18:393-400. [PMID: 19647484 DOI: 10.1016/j.hlc.2009.05.706] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 03/19/2009] [Accepted: 05/12/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED The aim of this study was to determine the degree of p38 mitogen-activated protein kinase (p38 MAPK) activation in rat heart and lungs after experimentally induced brain death and to test whether SD-282, a synthetic and selective small molecule inhibitor of p38 MAPK, abrogates p38 MAPK activation invoked by this brain death model. METHODS Adult male Sprague Dawley rats were treated with vehicle (control, n=7) or SD-282 (40mg/kg, n=6), for 15min prior to the induction of brain death and maintained with ventilatory support for 3h. IL-6 and TNFalpha were measured in plasma, heart and lungs using ELISA, and p38 MAPK via Western blot assay. RESULTS p38 MAPK inhibition was demonstrated by lower p38 MAPK activity in lungs from SD-282-treated donors compared to control (Median [inter-quartile range]: 13.6[4.0-19.0]% vs 20.2[14.7-31.5]% activity, p=0.06). Although levels varied, significant inhibition of p38 MAPK by SD-282 was not observed in the heart. SD-282 significantly lowered IL-6 and TNFalpha values compared to control in plasma (64[51-81]pg/ml vs 352[200-755]pg/ml, p=0.003 and 4.3[1.5-9.0]pg/ml vs 21.1[10.5-31.5]pg/ml, p=0.015, respectively) and lungs (0.14[0.12-0.62] vs 5.8[3.6-6.0]pg/mg protein, p=0.03 and 0.41[0.33-0.45] vs 2.1[1.4-2.7]pg/mg protein, p=0.0027, respectively), however SD-282 did not significantly affect cardiac cytokine levels. CONCLUSIONS p38 MAPK inhibition with SD-282 decreases the pro-inflammatory response as represented by lower IL-6 and TNFalpha in plasma and lungs following brain death. However, although in heart this response was variable, no significant effect could be demonstrated under the present conditions.
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Affiliation(s)
- Takahiro Oto
- Department of Cardiothoracic Surgery, Alfred Hospital, Monash University, Melbourne, Australia
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