a1_With hypoxic stress, hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) are elevated and their responses are altered in skeletal muscles of plateau animals [China Qinghai-Tibetan plateau pikas (Ochotona curzoniae )] as compared with control animals [normal lowland Sprague-Dawley (SD) rats]. The results indicate that HIF-1α and VEGF are engaged in physiological functions under hypoxic environment. The purpose of the current study was to examine the protein levels of VEGF receptor subtypes (VEGFRs: VEGFR-1, VEGFR-2 and VEGFR-3) in the end organs, namely skeletal muscle, heart and lung in response to hypoxic stress. ELISA and Western blot analysis were employed to determine HIF-1α and the protein expression of VEGFRs in control animals and plateau pikas. We further blocked HIF-1α signal to determine if HIF-1α regulates alternations in VEGFRs in those tissues. We hypothesized that responsiveness of VEGFRs in the major end organs of plateau animals is differential with insult of hypoxic stress and is modulated by low oxygen sensitive HIF-1α. Our results show that hypoxic stress induced by exposure of lower O2 for 6 h significantly increased the levels of VEGFR-2 in skeletal muscle, heart and lung and the increases were amplified in plateau pikas. Our results also demonstrate that hypoxic stress enhanced VEGFR-3 in lungs of plateau animals. Nonetheless, no significant alternations in VEGFR-1 were observed in those tissues with hypoxic stress. Moreover, we observed decreases of VEGFR-2 in skeletal muscle, heart and lung; and decreases of VEGFR-3 in lung following HIF-1α inhibition. Overall, our findings suggest that in plateau animals 1) responsiveness of VEGFRs is different under hypoxic environment; 2) amplified VEGFR-2 response appears in skeletal muscle, heart and lung, and enhanced VEGFR-3 response is mainly observed in lung; 3) HIF-1α plays a regulatory role in the levels of VEGFRs. Our results provide the underlying cellular and molecular mechanisms responsible for hypoxic environment in plateau animals, having an impact on research of physiological and ecological adaptive responses to acute or chronic hypoxic stress in humans who living at high attitude and who live at a normal sea level but suffer from hypoxic disorders., H.-C. Xie, J.-G. Li, J.-P. He., and Obsahuje bibliografii
Acute lung injury (ALI) is associated with det erioration of alveolar-capillary lining and transmigration and activation of inflammatory cells. Whereas a selective phosphodiesterase-4 (PDE4) inhibitor roflumilast has exerted potent anti-inflammatory properties, this study evaluated if its intravenous delivery can influence inflammation, edema formation, and respiratory parameters in rabbits with a lavage-induced model of ALI. ALI was induced by repetitive saline lung lavage (30 ml/kg). Animals were divided into 3 groups: ALI without therapy (ALI), ALI treated with roflumilast i.v. (1 mg/kg; ALI+Rofl), and healthy ventilated controls (Control), and were ventilated for following 4 h. Respiratory parameters (blood gases, ventilatory pressures, lung compliance, oxygenation indexes etc.) were measured and ca lculated regularly. At the end of experiment, animals were overdosed by anesthetics. Total and differential counts of cells in bronchoalveolar lavage fluid (BAL) were estimated microscopically. Lung edema was expressed as wet/dry lung weight ratio. Treatment with roflumilast reduced leak of cells (P<0.01), particularly of neutrophils (P<0.001), into the lung, decreased lung edema formation (P<0.01), and improved respiratory parameters. Concluding, the results indicate a future potential of PDE4 inhibitors also in the therapy of ALI., P. Kosutova, P. Mikolka, M. Kolomaznik, S. Rezakova, A. Calkovska, D. Mokra., and Obsahuje bibliografii
Cíl. Retrospektivně analyzovat výsledky léčby plicních arteriovenózních zkratů (PAVZ) embolizací v prevenci paradoxní embolizace. Metoda. Do studie bylo zahrnuto 16 nemocných (7 mužů, 9 žen, průměrného věku 48,3 roků, v rozmezí 17-82 roků) s celkem 35 PAVZ. U šesti nemocných byly PAVZ jednoduché, u jednoho nemocného PAVZ diagnostikovaná na CT angiografii nebyla potvrzena. U devíti nemocných byly PAVZ vícečetné (2-11 zkratů). Zkraty byly u jedné třetiny v levé plíci, u jedné třetiny v pravé plíci a u třetiny nemocných oboustranně. Pouze u dvou nemocných s vícečetnými PAVZ byly zkraty uloženy v horních plicních polích, jinak vždy ve středních a dolních. U 12 nemocných byla prokázána hemoragická hereditární teleangiektázie (HHT). Bylo provedeno 18 embolizačních sezení, u dvou nemocných byla provedena pouze angiografie, z toho u jednoho nebyl zkrat prokázán a jeden nemocný byl léčen pneumonektomií. Výsledky. Všechny PAVZ byly na konci embolizace bez angiograficky průkazného průtoku. U dvou nemocných došlo k rekanalizaci zkratu, což se projevilo nárůstem dusnosti. Další nemocná původně léčená na jiném pracovišti měla emb olizovány dvě rekanalizované PAVZ. Jedna nemocná se sekundární epilepsií po prodělaném mozkovém abscesu náhle zemřela 3 měsíce po embolizaci zkratu, nejspíše v důsledku epileptického záchvatu. Jeden nemocný byl ztracen ze sledování. Ostatní nemocní jsou bez potíží. Závěr. Embolizace je primární léčebnou metodou při uzávěru PAVZ v prevenci paradoxní embolizace. Nemocní s HHT vyžadují trvalou péči., Aim. Results of the pulmonary arteriovenous shunts (PAVS) embolization therapy in prevention of paradoxical embolization are retrospectively analysed. Material and methods. The study included 16 patients (7 males, 9 females of average age 48.3 years, range 17-82 years) with 35 PAVS. The single shunt was present in 6 patients, a shunt diagnosed on CT angiography was not confirmed on angiogram in one patient. The multiple PAVS (from 2 to 11) were diagnosed in 9 patients. The PAVS were in the left lung in one third of patients, in the right lung in another third of patients, and on the both sides in the remaining third of patients. The PAVS were located in the upper lobes only in 2 patients, who both had multiple PAVS. The other PAVS were located in the middle and lower pulmonary fields. The hemorrhagic hereditary teleangiectasia (HHT) was confirmed in 12 patients. The authors performed 18 embolization sessions, in two patients only diagnostic angiogram was done, since the PAVS was not confirmed in one patients and one patient was treated by pneumonectomy. Results. All embolized PAVS were angiographically occluded in the end of the procedure. Recanalization of the PAVS occurred in 2 patients with dyspnoe. Another patient had reembolization of two PAVS after primary treatment in another hospital. One patient with epilepsy secondary to the brain abscess suddenly died 3 months after embolization, most probably due to epileptic seizure. One patient was lost for follow-up. Remaining patients have been doing well. Conclusion. Embolization is the primary method of the PAVS occlusion in prevention of paradoxical embolization. The patients with HHT require permanent care., Antonín Krajina, Vladimír Koblížek, Miroslav Lojík, Jan Raupach, Vendelín Chovanec, Ondřej Renc, Eva Plodrová, Jan Hájek, Leo Steinhart, and Literatura 40
We measured hormonal levels in blood samples from pulmonary and radial arteries in 117 patients undergoing aorto-coronary by-pass surgery with the aim of investigating the role of the pulmonary vessel endothelium in hormone metabolism. Insulin and glucagon concentrations were significantly higher in pulmonary artery blood with respect to radial artery blood (73±65 vs. 65±47 pmol/l, p<0.005, and 80+49 vs. 73+51 ng/l, p<0.01, respectively), while no difference was found for growth hormone, prolactin, C peptide, insulin-like growth factor I, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, parathyroid hormone, thyroglobulin, triiodothyronine, thyroxine, free triiodothyronine, and free thyroxine. Moreover, prolactin concentrations were more than twice the normal levels, this being an effect of propafol and the opiate fentanyl used for the general anesthesia. Assuming that the arteriovenous differences observed are a marker of peptide hormone degradation, our study has demonstrated that with similar kinetics insulin and glucagon secreted into portal circulation and escaping from hepatic extraction undergo further homeostatic removal of about 9-10 % in the pulmonary circulation before entering the general circulation., G. Aliberti, I. Pulignano, M. Proietta, F. Miraldi, L. Cigognetti, L. Tritapepe, C. Di Giovanni, R. Arzilla, E. Vecci, M. Toscano., and Obsahuje bibliografii
Hypoxic exposure triggers a generation of reactive oxygen species that initiate free radical damage to the lung. Hydrogen peroxide is the product of alveolar macrophages detectable in the expired breath. We evaluated the significance of breath H2O2 concentration for the assessment of lung damage after hypoxic exposure and during posthypoxic period. Adult male rats were exposed to normobaric hypoxia (10 % O2) for 3 hours or 5 days. Immediately after the hypoxic exposure and then after 7 days or 14 days of air breathing, H2O2 was determined in the breath condensate and in isolated lung macrophages. Lipid peroxidation was measured in lung homogenates. Three-hour hypoxia did not cause immediate increase in the breath H2O2; 5-day hypoxia increased breath H2O2 level to 458 %. After 7 days of subsequent air breathing H2O2 was elevated in both groups exposed to hypoxia. Increased production of H2O2 by macrophages was observed after 5 days of hypoxia and during the 7 days of subsequent air breathing. Lipid peroxidation increased in the periods of enhanced H2O2 generation by macrophages. As the major increase (1040 %) in the breath H2O2 concentration found 7 days after 3 hours of hypoxia was not accompanied by lipid peroxidation, it can be concluded that the breath H2O2 is not a reliable indicator of lung oxidative damage., J. Wilhelm, M. Vaňková, H. Maxová, A. Šišková., and Obsahuje bibliografii
Chronic hypoxia results in hypoxic pulmonary hypertension characterized by fibrotization and muscularization of the walls of peripheral pulmonary arteries. This vessel remodeling is accompanied by an increase in the amount of lung mast cells (LMC) and the presence of small collagen cleavage products in the vessel walls. We hypothesize that hypoxia activates LMC, which release matrix metalloproteinases (MMPs) cleaving collagen and starting increased turnover of connective tissue proteins. This study was designed to determine whether in vitro hypoxia stimulates production of MMPs in rat LMC and increases their collagenolytic activity. The LMC were separated on the Percoll gradient and then were divided into two groups and cultivated for 24 h in 21 % O2 + 5 % CO2 or in 10 % O2 + 5 % CO2. Presence of the rat interstitial tissue collagenase (MMP-13) in LMC was visualized by immunohistological staining and confirmed by Western blot analysis. Total MMPs activity and tryptase activity were measured in both cultivation media and cellular extracts. Exposure to hypoxia in vitro increased the amount of cells positively labeled by anti-MMP-13 antibody as well as activities of all measured enzymes. The results therefore support the concept that LMC are an important source of increased collagenolytic activity in chronic hypoxia., H. Maxová, J. Novotná, L. Vajner, H. Tomášová, R. Vytášek, M. Vízek, L. Bačáková, V. Valoušková, T. Eliášová, J. Herget., and Obsahuje bibliografii a bibliografické odkazy
Neurogenic pulmonary edema is a life-threatening complication, known for almost 100 years, but its etiopathogenesis is still not completely understood. This review summarizes current knowledge about the etiology and pathophysiology of neurogenic pulmonary edema. The roles of systemic sympathetic discharge, central nervous system trigger zones, intracranial pressure, inflammation and anesthesia in the etiopathogenesis of neurogenic pulmonary edema are considered in detail. The management of the patient and experimental models of neurogenic pulmonary edema are also discussed., J. Šedý, J. Zicha, J. Kuneš, P. Jendelová, E. Syková., and Obsahuje bibliografii a bibliografické odkazy
Základem stati jsou náčrty transverzálních řezů plic s vyznačením obvyklých hranic mezi jednotlivými plicními dílci (segmenty) a stručný přehled nejčastějších variací anatomického uspořádání plic a upozornění na vývoj jejich názvosloví., Core of this text are drawings of transversal sections of lungs showing the usual boundaries between individual lung segments and a brief overview of the most common anatomic variation of lung structure and a notice on the development of their Czech nomenclature., Tomáš Kolín, and Literatura 8
The respiratory system is constantly exposed to pathogens which enter the lungs by inhalation or via blood stream. Lipopolysaccharide (LPS), also named endotoxin, can reach the airspaces as the major component of the outer membrane of Gram-negative bacteria, and lead to local inflammation and systemic toxicity. LPS affects alveolar type II (ATII) cells an d pulmonary surfactant and although surfactant molecule has the effective protective mechanisms, excessive amount of LPS interacts with surfactant film and leads to its inactivation. From immunological point of view, surfactant specific proteins (SPs) SP-A and SP-D are best characterized, however, there is increasing evidence on the involvement of SP-B and SP-C and certain phospholipids in immune reactions. In animal models, the instillation of LPS to the respiratory system induces acute lung injury (ALI). It is of clinical importance that endotoxin-induced lung injury can be favorably influenced by intratracheal instillation of exogenous surfactant. The beneficial effect of this treatment was confirmed for both natural porcine and synthetic surfactants. It is believed that the surfactant preparations have anti-inflammatory properties through regulating cytokine production by inflammatory cells. The mechanism by which LPS interferes with ATII cells and surfactant layer, and its consequences are discussed below., M. Kolomaznik, Z. Nova, A. Calkovska., and Obsahuje bibliografii
Neonatal exposure to hyperoxia alters lung development in mice. We tested if retinoic acid (RA) treatment is capable to affect lung development after hyperoxic injury and to maintain structural integrity of lung. The gene of vascular endothelial growth factor A (VEGF-A) is one of the RA-responsive genes. Newborn BALB/c mice were exposed to room air, 40 % or 80 % hyperoxia for 7 days. One half of animals in each group received 500 mg/kg retinoic acid from day 3 to day 7 of the experiment. At the end of experiment we assessed body weight (BW), lung wet weight (LW), the wet-to-dry lung weight ratio (W/D) and the expression of mRNA for VEGF-A and G3PDH genes. On day 7 the hyperoxia-exposed sham-treated mice (group 80) weighed 20 % less than the room air-exposed group, whereas the 80 % hyperoxic group treated with RA weighed only 13 % less than the normoxic group. W/D values in 80 and 80A groups did not differ, although they both differed from the control group and from 40 groups. There was a significant difference between 40 and 40A groups, but the control group was different from 40 group but not from 40A groups. The 80 and 80A groups had mRNA VEGF-A expression lowered to 64 % and 41 % of the control group. RA treatment of normoxic and mild hyperoxic groups increased mRNA VEGF-A expression by about 50 %. We conclude that the retinoic acid treatment of newborn BALB/c mice exposed for 7 days to 80 % hyperoxia reduced the growth retardation in the 80 % hyperoxic group, reduced the W/D ratio in the 40 % but not in the 80 % hyperoxic group. Higher VEGF-A mRNA expression in the 80 % hyperoxic group treated with RA was not significant compared to the 80 % hyperoxic group., M. Zimová-Herknerová, J. Mysliveček, P. Potměšil., and Obsahuje bibliografii a bibliografické odkazy