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Role of the renin-angiotensin system in ventilator-induced lung injury: an in vivo study in a rat model.


ABSTRACT:

Background

Injurious mechanical ventilation can cause a pro-inflammatory reaction in the lungs. Recent evidence suggests an association of the renin-angiotensin system (RAS) with lung inflammation. A study was undertaken to investigate the pathogenic role of the RAS in ventilator-induced lung injury (VILI) and to determine whether VILI can be attenuated by angiotensin converting enzyme (ACE) inhibition.

Methods

Male Sprague-Dawley rats were mechanically ventilated for 4 h with low (7 ml/kg) or high (40 ml/kg) tidal volumes; non-ventilated rats were used as controls. Lung injury and inflammation were measured by the lung injury score, protein leakage, myeloperoxidase activity, pro-inflammatory cytokine levels and nuclear factor (NF)-kappaB activity. Expression of the RAS components was also assessed. Some rats were pretreated with the ACE inhibitor captopril (10 mg/kg) for 3 days or received a concomitant infusion with losartan or PD123319 (type 1 or type 2 angiotensin II receptor antagonist) during mechanical ventilation to assess possible protective effects on VILI.

Results

In the high-volume group (n=6) the lung injury score, bronchoalveolar lavage fluid protein concentration, pro-inflammatory cytokines and NF-kappaB activities were significantly increased compared with controls (n=6). Lung tissue angiotensin II levels and mRNA levels of angiotensinogen and type 1 and type 2 angiotensin II receptors were also significantly increased in the high-volume group. Pretreatment with captopril or concomitant infusion with losartan or PD123319 in the high-volume group attenuated the lung injury and inflammation (n=6 for each group).

Conclusions

The RAS is involved in the pathogenesis of ventilator-induced lung injury. ACE inhibitor or angiotensin receptor antagonists can attenuate VILI in this rat model.

SUBMITTER: Jerng JS 

PROVIDER: S-EPMC2117227 | biostudies-literature | 2007 Jun

REPOSITORIES: biostudies-literature

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Role of the renin-angiotensin system in ventilator-induced lung injury: an in vivo study in a rat model.

Jerng Jih-Shuin JS   Hsu Yu-Chiao YC   Wu Huey-Dong HD   Pan Hong-Zhen HZ   Wang Hao-Chien HC   Shun Chia-Tung CT   Yu Chong-Jen CJ   Yang Pan-Chyr PC  

Thorax 20070118 6


<h4>Background</h4>Injurious mechanical ventilation can cause a pro-inflammatory reaction in the lungs. Recent evidence suggests an association of the renin-angiotensin system (RAS) with lung inflammation. A study was undertaken to investigate the pathogenic role of the RAS in ventilator-induced lung injury (VILI) and to determine whether VILI can be attenuated by angiotensin converting enzyme (ACE) inhibition.<h4>Methods</h4>Male Sprague-Dawley rats were mechanically ventilated for 4 h with low  ...[more]

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