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2 Division of Pulmonary and Critical Care Medicine, Departments of 1 Anesthesia and Critical Care and Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21224
Apocynin
(4-hydroxy-3-methoxy-acetophenone) inhibits NADPH oxidase in activated
polymorphonuclear (PMN) leukocytes, preventing the generation of
reactive oxygen species. To determine if apocynin attenuates
ischemia-reperfusion lung injury, we examined the effects of apocynin
(0.03, 0.3, and 3 mM) in isolated in situ sheep lungs. In
diluent-treated lungs, reperfusion with blood (180 min) after 30 min of
ischemia (ventilation 28% O2, 5% CO2) caused
leukocyte sequestration in the lung and increased vascular permeability [reflection coefficient for albumin (
alb) 0.47 ± 0.10, filtration coefficient (Kf) 0.14 ± 0.03 g · min
1 · mmHg
1
· 100 g
1] compared with nonreperfused lungs
(
alb 0.77 ± 0.03, Kf
0.03 ± 0.01 g · min
1 · mmHg
1 · 100 g
1; P < 0.05). Apocynin attenuated the increased protein permeability at 0.3 and 3 mM (
alb 0.69 ± 0.05 and 0.91 ± 0.03, respectively, P < 0.05); Kf was
decreased by 3 mM apocynin (0.05 ± 0.01 g · min
1 · mmHg
1 · 100 g
1, P < 0.05). Diphenyleneiodonium (DPI,
5 µM), a structurally unrelated inhibitor of NADPH oxidase, worsened
injury (Kf 0.32 ± 0.07 g · min
1 · mmHg
1 · 100 g
1, P < 0.05). Neither apocynin nor DPI
affected leukocyte sequestration. Apocynin and DPI inhibited whole
blood chemiluminescence and isolated PMN leukocyte-induced resazurin
reduction, confirming NADPH oxidase inhibition. Apocynin inhibited
pulmonary artery hypertension and perfusate concentrations of
cyclooxygenase metabolites, including thromboxane B2. The
cyclooxygenase inhibitor indomethacin had no effect on the increased
vascular permeability, suggesting that cyclooxygenase inhibition was
not the explanation for the apocynin results. Apocynin prevented
ischemia-reperfusion lung injury, but the mechanism of protection
remains unclear.
sheep; diphenyleneiodonium; pulmonary edema; vascular permeability
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