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Department of Biological Psychiatry, University of Groningen, 9700 RB Groningen, The Netherlands
The following is the abstract of the article discussed in the subsequent letter:
Worrall, Neil K., Kathy Chang, Wanda S. LeJeune,
Thomas P. Misko, Patrick M. Sullivan, T. Bruce Ferguson, Jr., and
Joseph R. Williamson. TNF-
causes reversible in vivo systemic
vascular barrier dysfunction via NO-dependent and -independent
mechanisms. Am. J. Physiol. 273 (Heart Circ.
Physiol. 42): H2565-H2574, 1997.
Tumor necrosis factor
(TNF-
) and nitric oxide (NO) are important vasoactive mediators of
septic shock. This study used a well-characterized quantitative
permeation method to examine the effect of TNF-
and NO on systemic
vascular barrier function in vivo, without confounding endotoxemia,
hypotension, or organ damage. Our results showed 1)
TNF-
reversibly increased albumin permeation in the systemic
vasculature (e.g., lung, liver, brain, etc.); 2) TNF-
did not affect hemodynamics or blood flow or cause significant tissue
injury; 3) pulmonary vascular barrier dysfunction was
associated with increased lung water content and impaired oxygenation;
4) TNF-
caused inducible nitric oxide synthase (iNOS)
mRNA expression in the lung and increased in vivo NO production;
5) selective inhibition of iNOS with aminoguanidine
prevented TNF-
-induced lung and liver vascular barrier dysfunction;
6) aminoguanidine prevented increased tissue water content
in TNF-
-treated lungs and improved oxygenation; and 7)
nonselective inhibition of NOS with
NG-monomethyl-L-arginine increased
vascular permeation in control lungs and caused severe lung injury in
TNF-
-treated animals. We conclude that 1) TNF-
reversibly impairs vascular barrier integrity through NO-dependent and
-independent mechanisms; 2) nonselective NOS inhibition
increased vascular barrier dysfunction and caused severe lung injury,
whereas selective inhibition of iNOS prevented impaired endothelial
barrier integrity and pulmonary dysfunction; and 3)
selective inhibition of iNOS may be beneficial in treating increased
vascular permeability that complicates endotoxemia and cytokine immunotherapy.
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