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Endothelin-1 in acute lung injury and the adult respiratory distress syndrome.
- Source :
-
The American review of respiratory disease [Am Rev Respir Dis] 1993 Dec; Vol. 148 (6 Pt 1), pp. 1646-50. - Publication Year :
- 1993
-
Abstract
- Endothelial damage is a hallmark of acute lung injury. Endothelial mediators may increase pulmonary vascular tone and induce pulmonary arterial muscularization, thereby contributing to the pulmonary hypertension seen with acute lung injury. We measured plasma levels and net pulmonary clearance of endothelin-1, a potent endothelium-derived vasoconstrictor peptide and smooth muscle mitogen, in 26 patients with early acute lung injury, the adult respiratory distress syndrome, and pulmonary hypertension. Nineteen had another data collection at clinical improvement or worsening. Control subjects (n = 25) had no pulmonary hypertension or lung injury. Initial mixed venous and systemic arterial plasma endothelin-1 levels were elevated (4.6 +/- 0.6 SEM and 4.9 +/- 0.6 pg/ml, respectively) as compared with control subjects (0.9 +/- 0.1 and 0.6 +/- 0.1 pg/ml). The systemic arterial/venous endothelin-1 ratio was 1.1 +/- 0.1 (0.7 +/- 0.1 in control subjects), indicating a reduction in normal net pulmonary endothelin-1 clearance. With clinical improvement, as compared with clinical worsening, mean plasma endothelin-1 levels, arterial/venous ratio, and pulmonary arterial pressure fell significantly towards normal. Thus, patients with acute lung injury have marked early increases in circulating plasma endothelin-1 levels, associated with abnormal pulmonary endothelin-1 metabolism. These abnormalities reverse in patients who recover. Through its actions, endothelin-1 could contribute to the pulmonary hypertension seen in acute lung injury.
- Subjects :
- Blood Pressure
Female
Humans
Hypertension, Pulmonary blood
Hypertension, Pulmonary etiology
Male
Middle Aged
Prognosis
Pulmonary Artery physiopathology
Respiratory Distress Syndrome complications
Respiratory Distress Syndrome physiopathology
Endothelins blood
Respiratory Distress Syndrome blood
Subjects
Details
- Language :
- English
- ISSN :
- 0003-0805
- Volume :
- 148
- Issue :
- 6 Pt 1
- Database :
- MEDLINE
- Journal :
- The American review of respiratory disease
- Publication Type :
- Academic Journal
- Accession number :
- 8256914
- Full Text :
- https://doi.org/10.1164/ajrccm/148.6_Pt_1.1646