Hydrogen sulfide-curiouser and curiouser!*

H2S in acute lung injury: a therapeutic dead end(?)

This review addresses the plausibility of hydrogen sulfide (H₂S) therapy for acute lung injury (ALI) and circulatory shock, by contrasting the promising preclinical results to the present clinical reality. The review discusses how the narrow therapeutic window and width, and potentially toxic effects, the route, dosing, and timing of administration all have to be balanced out very carefully. The development of standardized methods to determine in vitro and in vivo H₂S concentrations, and the pharmacokinetics and pharmacodynamics of H₂S-releasing compounds is a necessity to facilitate the safety of H₂S-based therapies. We suggest the potential of exploiting already clinically approved compounds, which are known or unknown H₂S donors, as a surrogate strategy.

Hydrogen sulfide: physiological properties and therapeutic potential in ischaemia

Hydrogen sulfide (H2 S) has become a molecule of high interest in recent years, and it is now recognized as the third gasotransmitter in addition to nitric oxide and carbon monoxide. In this review, we discuss the recent literature on the physiology of endogenous and exogenous H2 S, focusing upon the protective effects of hydrogen sulfide in models of hypoxia and ischaemia.

Torpor and hypothermia: reversed hysteresis of metabolic rate and body temperature

Regulated torpor and unregulated hypothermia are both characterized by substantially reduced body temperature (Tb) and metabolic rate (MR), but they differ physiologically. Although the remarkable, medically interesting adaptations accompanying torpor (e.g., tolerance for cold and ischemia, absence of reperfusion injury, and disuse atrophy) often do not apply to hypothermia in homeothermic species such as humans, the terms "torpor" and "hypothermia" are often used interchangeably in the literature. To determine how these states differ functionally and to provide a reliable diagnostic tool for differentiating between these two physiologically distinct states, we examined the interrelations between Tb and MR in a mammal (Sminthopsis macroura) undergoing a bout of torpor with those of the hypothermic response of a similar-sized juvenile rat (Rattus norvegicus). Our data show that under similar thermal conditions, 1) cooling rates differ substantially (approximately fivefold) between the two states; 2) minimum MR is approximately sevenfold higher during hypothermia than during torpor despite a similar Tb; 3) rapid, endogenously fuelled rewarming occurs in torpor but not hypothermia; and 4) the hysteresis between Tb and MR during warming and cooling proceeds in opposite directions in torpor and hypothermia. We thus demonstrate clear diagnostic physiological differences between these two states that can be used experimentally to confirm whether torpor or hypothermia has occurred. Furthermore, the data can clarify the results of studies investigating the ability of physiological or pharmacological agents to induce torpor. Consequently, we recommend using the terms "torpor" and "hypothermia" in ways that are consistent with the underlying regulatory differences between these two physiological states.

Oxygen deficit and H2S in hemorrhagic shock in rats

Introduction

Hemorrhagic shock induced O₂ deficit triggers inflammation and multiple organ failure (MOF). Endogenous H₂S has been proposed to be involved in MOF since plasma H₂S concentration appears to increase in various types of shocks and to predict mortality. We tested the hypothesis that H₂S increases during hemorrhagic shock associated with O₂ deficit, and that enhancing H₂S oxidation by hydroxocobalamin could reduce inflammation, O₂ deficit or mortality.

Methods

We used a urethane anesthetized rat model, where 25 ml/kg of blood was withdrawn over 30 minutes. O₂ deficit, lactic acid, tumor necrosis factor (TNF)-alpha and H₂S plasma concentrations (Siegel method) were measured before and after the bleeding protocol in control animals and animals that received 140 mg/kg of hydroxocobalamin. The ability to oxidize exogenous H₂S of the plasma and supernatants of the kidney and heart homogenates was determined in vitro.

Results

We found that withdrawing 25 ml/kg of blood led to an average oxygen deficit of 122 ± 23 ml/kg. This O₂ deficit was correlated with an increase in the blood lactic acid concentration and mortality. However, the low level of absorbance of the plasma at 670 nm (A₆₇₀), after adding N, N-Dimethyl-p-phenylenediamine, that is, the method used for H₂S determination in previous studies, did not reflect the presence of H₂S, but was a marker of plasma turbidity. There was no difference in plasmatic A₆₇₀ before and after the bleeding protocol, despite the large oxygen deficit. The plasma sampled at the end of bleeding maintained a very large ability to oxidize exogenous H₂S (high μM), as did the homogenates of hearts and kidneys harvested just after death. Hydroxocobalamin concentrations increased in the blood in the μM range in the vitamin B12 group, and enhanced the ability of plasma and kidneys to oxidize H₂S. Yet, the survival rate, O₂ deficit, H₂S plasma concentration, blood lactic acid and TNF-alpha levels were not different from the control group.

Conclusions

In the presence of a large O₂ deficit, H₂S did not increase in the blood in a rat model of untreated hemorrhagic shock. Hydroxocobalamin, while effective against H₂S in vitro, did not affect the hemodynamic profile or outcome in our model.