PGE1, dexamethasone, U-74389G, or Bt2-cAMP as an additive to promote protection by UW solution in I/R injury

Chiang, Chi-Huei, Kang Hsu, Horng-Chin Yan, Horng-Jyh Harn,and Deh-Ming Chang.PGE₁, dexamethasone,U-74389G, or Bt₂-cAMP as anadditive to promote protection by UW solution in I/R injury. J. Appl. Physiol. 83(2): 583-590, 1997.A method to reduce ischemia-reperfusion (I/R) injury can be animportant criterion to improve the preservation solution. AlthoughUniversity of Wisconsin solution (UW) works as a lung preservationsolution, its attenuation effect on I/R injury has not beeninvestigated. We attempted to determine whether, by adding variousprotective agents, modified UW solutions will enhance the I/Rattenuation by UW. We examined the I/R injury in an isolated rat lungmodel. Various solutions, e.g., physiological salt solution (PSS), UW,and modified UW solutions containing various protective agents such asprostaglandin E₁, dexamethasone, U-74389G, or dibutyryl adenosine 3,5-cyclic monophosphatewere perfused individually to evaluate the I/R injury. Isolated rat lung experiments, with ischemia for 45 min, then reperfusion for 60 min, were conducted in a closed circulating system.Hemodynamic changes, lung weight gain (LWG), capillary filtrationcoefficient (K_fc), proteincontent of lavage fluid, concentration of cytokines, and lunghistopathology were analyzed. Results showed that the acute I/R lunginjury with immediate permeability pulmonary edema was associated withan increase in tumor necrosis factor- (TNF-) production. A significant correlation existed betweenTNF- and K_fc(r = 0.8, P < 0.0001) and TNF- and LWG(r = 0.9, P < 0.0001), indicatingthat TNF- is an important cytokine modulating early I/R injury.Significantly lower levels ofK_fc, LWG,TNF-, and protein concentration of lung lavage(P < 0.05) were found in theUW-perfused group than in the control group perfused with PSS. ModifiedUW promoted the protective effect of UW to further decreaseK_fc, LWG, andTNF- (P < 0.05).Histopathological observations also substantiated this evidence. In theUW+U-74389G group, bronchial alveolar lavage fluid contained lowestprotein concentration. We conclude that the UW solution attenuates I/Rinjury of rat lung and that the modified UW solutions further enhancethe effect of UW in reducing I/R injury. Among modified solutions,UW+U-74389G is the best. Further investigation of the improved effectsof the modified UW solutions would be beneficial in lungtransplantation.