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Am J Physiol Heart Circ Physiol 275: H1910-H1911, 1998;
0363-6135/98 $5.00
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Vol. 275, Issue 5, H1910-H1911, November 1998

Letters to the Editor

Gert J. Ter Horst

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-alpha 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-alpha ) 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-alpha and NO on systemic vascular barrier function in vivo, without confounding endotoxemia, hypotension, or organ damage. Our results showed 1) TNF-alpha reversibly increased albumin permeation in the systemic vasculature (e.g., lung, liver, brain, etc.); 2) TNF-alpha 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-alpha 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-alpha -induced lung and liver vascular barrier dysfunction; 6) aminoguanidine prevented increased tissue water content in TNF-alpha -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-alpha -treated animals. We conclude that 1) TNF-alpha 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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