Inducible nitric oxide synthase dimerization inhibitor prevents cardiovascular and renal morbidity in sheep with combined burn and smoke inhalation injury

Perenlei Enkhbaatar, Kazunori Murakami, Katsumi Shimoda, Akio Mizutani, Lillian Traber, Gary Phillips, John Parkinson, John R. Salsbury, Nettie Biondo, Frank Schmalstieg, Ann Burke, Robert Cox, Hal Hawkins, David Herndon, Daniel Traber

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Inducible nitric oxide synthase (iNOS) is implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). ARDS treatment is frequently complicated by significant extrapulmonary comorbidity. This study was designed to clarify the role of iNOS in mediating extrapulmonary comorbidity in sheep after combined burn and smoke inhalation injuries using a potent and highly selective iNOS dimerization inhibitor, BBS-2. Twenty-two female sheep were operatively prepared. After 5 days of recovery, tracheostomy was performed under ketamine-halothane anesthesia. Sheep were given a 40% total body surface third-degree burns and insufflated with cotton smoke (48 breaths, <40°C). Sheep were divided into four groups: noninjured and nontreated (sham group; n = 6), noninjured but treated with BBS-2 (sham/BBS-2 group; n = 4), injured but nontreated (control group, n = 6), and injured but treated with 100 μg·kg-1·h-1 BBS-2 (BBS-2 group; n = 6). Evaluation was in a laboratory intensive care unit setting for 48 h. The sham group had stable cardiopulmonary and systemic hemodynamics. Control animals showed multiple signs of morbidity. Decreased left ventricular stroke work index and stroke volume index with elevated left atrial pressure indicated myocardial depression. Systemic vascular leak was evidenced by robust hemoconcentration, decreased plasma oncotic pressure, and increased transvascular fluid flux into the lymphatic system. Finally, severely impaired renal function (urinary output) was associated with adverse net fluid balance. Treatment with BBS-2 prevented all these morbidities without adversely effecting cardiovascular hemodynamics such as cardiac index and mean arterial pressure. The results identify a major role for iNOS in mediating extrapulmonary comorbidity in a clinically relevant and severe trauma model and support the use of highly selective iNOS inhibitors as novel treatments in critical care medicine.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume285
Issue number6 54-6
StatePublished - Dec 2003

Fingerprint

Smoke Inhalation Injury
Dimerization
Nitric Oxide Synthase Type II
Sheep
Morbidity
Kidney
Comorbidity
Adult Respiratory Distress Syndrome
Hemodynamics
Lymphatic System
Atrial Pressure
Water-Electrolyte Balance
Tracheostomy
Ketamine
Halothane
Critical Care
Burns
Smoke
Stroke Volume
Blood Vessels

Keywords

  • Heart
  • Kidney

ASJC Scopus subject areas

  • Physiology

Cite this

Inducible nitric oxide synthase dimerization inhibitor prevents cardiovascular and renal morbidity in sheep with combined burn and smoke inhalation injury. / Enkhbaatar, Perenlei; Murakami, Kazunori; Shimoda, Katsumi; Mizutani, Akio; Traber, Lillian; Phillips, Gary; Parkinson, John; Salsbury, John R.; Biondo, Nettie; Schmalstieg, Frank; Burke, Ann; Cox, Robert; Hawkins, Hal; Herndon, David; Traber, Daniel.

In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 285, No. 6 54-6, 12.2003.

Research output: Contribution to journalArticle

Enkhbaatar, P, Murakami, K, Shimoda, K, Mizutani, A, Traber, L, Phillips, G, Parkinson, J, Salsbury, JR, Biondo, N, Schmalstieg, F, Burke, A, Cox, R, Hawkins, H, Herndon, D & Traber, D 2003, 'Inducible nitric oxide synthase dimerization inhibitor prevents cardiovascular and renal morbidity in sheep with combined burn and smoke inhalation injury', American Journal of Physiology - Heart and Circulatory Physiology, vol. 285, no. 6 54-6.
Enkhbaatar, Perenlei ; Murakami, Kazunori ; Shimoda, Katsumi ; Mizutani, Akio ; Traber, Lillian ; Phillips, Gary ; Parkinson, John ; Salsbury, John R. ; Biondo, Nettie ; Schmalstieg, Frank ; Burke, Ann ; Cox, Robert ; Hawkins, Hal ; Herndon, David ; Traber, Daniel. / Inducible nitric oxide synthase dimerization inhibitor prevents cardiovascular and renal morbidity in sheep with combined burn and smoke inhalation injury. In: American Journal of Physiology - Heart and Circulatory Physiology. 2003 ; Vol. 285, No. 6 54-6.
@article{ebdeb280e853403c823cd945eb5c145e,
title = "Inducible nitric oxide synthase dimerization inhibitor prevents cardiovascular and renal morbidity in sheep with combined burn and smoke inhalation injury",
abstract = "Inducible nitric oxide synthase (iNOS) is implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). ARDS treatment is frequently complicated by significant extrapulmonary comorbidity. This study was designed to clarify the role of iNOS in mediating extrapulmonary comorbidity in sheep after combined burn and smoke inhalation injuries using a potent and highly selective iNOS dimerization inhibitor, BBS-2. Twenty-two female sheep were operatively prepared. After 5 days of recovery, tracheostomy was performed under ketamine-halothane anesthesia. Sheep were given a 40{\%} total body surface third-degree burns and insufflated with cotton smoke (48 breaths, <40°C). Sheep were divided into four groups: noninjured and nontreated (sham group; n = 6), noninjured but treated with BBS-2 (sham/BBS-2 group; n = 4), injured but nontreated (control group, n = 6), and injured but treated with 100 μg·kg-1·h-1 BBS-2 (BBS-2 group; n = 6). Evaluation was in a laboratory intensive care unit setting for 48 h. The sham group had stable cardiopulmonary and systemic hemodynamics. Control animals showed multiple signs of morbidity. Decreased left ventricular stroke work index and stroke volume index with elevated left atrial pressure indicated myocardial depression. Systemic vascular leak was evidenced by robust hemoconcentration, decreased plasma oncotic pressure, and increased transvascular fluid flux into the lymphatic system. Finally, severely impaired renal function (urinary output) was associated with adverse net fluid balance. Treatment with BBS-2 prevented all these morbidities without adversely effecting cardiovascular hemodynamics such as cardiac index and mean arterial pressure. The results identify a major role for iNOS in mediating extrapulmonary comorbidity in a clinically relevant and severe trauma model and support the use of highly selective iNOS inhibitors as novel treatments in critical care medicine.",
keywords = "Heart, Kidney",
author = "Perenlei Enkhbaatar and Kazunori Murakami and Katsumi Shimoda and Akio Mizutani and Lillian Traber and Gary Phillips and John Parkinson and Salsbury, {John R.} and Nettie Biondo and Frank Schmalstieg and Ann Burke and Robert Cox and Hal Hawkins and David Herndon and Daniel Traber",
year = "2003",
month = "12",
language = "English (US)",
volume = "285",
journal = "American Journal of Physiology - Endocrinology and Metabolism",
issn = "0193-1849",
publisher = "American Physiological Society",
number = "6 54-6",

}

TY - JOUR

T1 - Inducible nitric oxide synthase dimerization inhibitor prevents cardiovascular and renal morbidity in sheep with combined burn and smoke inhalation injury

AU - Enkhbaatar, Perenlei

AU - Murakami, Kazunori

AU - Shimoda, Katsumi

AU - Mizutani, Akio

AU - Traber, Lillian

AU - Phillips, Gary

AU - Parkinson, John

AU - Salsbury, John R.

AU - Biondo, Nettie

AU - Schmalstieg, Frank

AU - Burke, Ann

AU - Cox, Robert

AU - Hawkins, Hal

AU - Herndon, David

AU - Traber, Daniel

PY - 2003/12

Y1 - 2003/12

N2 - Inducible nitric oxide synthase (iNOS) is implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). ARDS treatment is frequently complicated by significant extrapulmonary comorbidity. This study was designed to clarify the role of iNOS in mediating extrapulmonary comorbidity in sheep after combined burn and smoke inhalation injuries using a potent and highly selective iNOS dimerization inhibitor, BBS-2. Twenty-two female sheep were operatively prepared. After 5 days of recovery, tracheostomy was performed under ketamine-halothane anesthesia. Sheep were given a 40% total body surface third-degree burns and insufflated with cotton smoke (48 breaths, <40°C). Sheep were divided into four groups: noninjured and nontreated (sham group; n = 6), noninjured but treated with BBS-2 (sham/BBS-2 group; n = 4), injured but nontreated (control group, n = 6), and injured but treated with 100 μg·kg-1·h-1 BBS-2 (BBS-2 group; n = 6). Evaluation was in a laboratory intensive care unit setting for 48 h. The sham group had stable cardiopulmonary and systemic hemodynamics. Control animals showed multiple signs of morbidity. Decreased left ventricular stroke work index and stroke volume index with elevated left atrial pressure indicated myocardial depression. Systemic vascular leak was evidenced by robust hemoconcentration, decreased plasma oncotic pressure, and increased transvascular fluid flux into the lymphatic system. Finally, severely impaired renal function (urinary output) was associated with adverse net fluid balance. Treatment with BBS-2 prevented all these morbidities without adversely effecting cardiovascular hemodynamics such as cardiac index and mean arterial pressure. The results identify a major role for iNOS in mediating extrapulmonary comorbidity in a clinically relevant and severe trauma model and support the use of highly selective iNOS inhibitors as novel treatments in critical care medicine.

AB - Inducible nitric oxide synthase (iNOS) is implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). ARDS treatment is frequently complicated by significant extrapulmonary comorbidity. This study was designed to clarify the role of iNOS in mediating extrapulmonary comorbidity in sheep after combined burn and smoke inhalation injuries using a potent and highly selective iNOS dimerization inhibitor, BBS-2. Twenty-two female sheep were operatively prepared. After 5 days of recovery, tracheostomy was performed under ketamine-halothane anesthesia. Sheep were given a 40% total body surface third-degree burns and insufflated with cotton smoke (48 breaths, <40°C). Sheep were divided into four groups: noninjured and nontreated (sham group; n = 6), noninjured but treated with BBS-2 (sham/BBS-2 group; n = 4), injured but nontreated (control group, n = 6), and injured but treated with 100 μg·kg-1·h-1 BBS-2 (BBS-2 group; n = 6). Evaluation was in a laboratory intensive care unit setting for 48 h. The sham group had stable cardiopulmonary and systemic hemodynamics. Control animals showed multiple signs of morbidity. Decreased left ventricular stroke work index and stroke volume index with elevated left atrial pressure indicated myocardial depression. Systemic vascular leak was evidenced by robust hemoconcentration, decreased plasma oncotic pressure, and increased transvascular fluid flux into the lymphatic system. Finally, severely impaired renal function (urinary output) was associated with adverse net fluid balance. Treatment with BBS-2 prevented all these morbidities without adversely effecting cardiovascular hemodynamics such as cardiac index and mean arterial pressure. The results identify a major role for iNOS in mediating extrapulmonary comorbidity in a clinically relevant and severe trauma model and support the use of highly selective iNOS inhibitors as novel treatments in critical care medicine.

KW - Heart

KW - Kidney

UR - http://www.scopus.com/inward/record.url?scp=0344440844&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344440844&partnerID=8YFLogxK

M3 - Article

VL - 285

JO - American Journal of Physiology - Endocrinology and Metabolism

JF - American Journal of Physiology - Endocrinology and Metabolism

SN - 0193-1849

IS - 6 54-6

ER -