iloprost and Acidosis

In newborn pig pial arterioles and cocultures of cerebral microvascular endothelial and smooth muscle cells, hypercapnia increases cAMP. In the intact cerebral circulation, both the increase in cAMP and the accompanying vasodilation require the presence of PGI(2). Using piglet cerebral microvascular smooth muscle in primary culture, we addressed the hypothesis that, in the presence of PGI(2), hypercapnia-induced changes in extracellular pH cause increases in cAMP. The stable PGI(2)-receptor agonist iloprost did increase production of cAMP in response to combined extracellular pH and pH(i) (11 +/- 6 vs. 32 +/- 10% in the absence and presence of 10(-10) M iloprost, respectively). However, there was no positive dose-response relationship between iloprost concentration and stimulation of cAMP production by acidosis (e.g., 58 +/- 9 vs. 41 +/- 5% in the presence of 10(-12) and 10(-9) M iloprost, respectively). Rapid decreases in pH(i) stimulate the cAMP production. Decreases in extracellular pH do not appear to contribute further. The G protein inhibitor pertussis toxin did not augment cAMP production in response to decreasing pH(i). We conclude that PGI(2) receptor activation permits another mechanism to enhance cAMP generation in response to intracellular, but not extracellular, acidosis and that the mechanism of the permissive effect of PGI(2) does not involve inhibition of a pertussis toxin-sensitive G protein.

Topics: Acidosis; Animals; Animals, Newborn; Cells, Cultured; Cerebrovascular Circulation; Culture Media; Cyclic AMP; Drug Synergism; Epoprostenol; Extracellular Space; GTP-Binding Proteins; Hydrogen-Ion Concentration; Iloprost; Intracellular Membranes; Muscle, Smooth, Vascular; Pertussis Toxin; Propionates; Receptors, Epoprostenol; Receptors, Prostaglandin; Swine; Virulence Factors, Bordetella

To determine the effects of the stable prostacyclin analog, iloprost, in a porcine model of endotoxin-induced mesenteric ischemia.. Prospective, experimental, randomized, controlled study.. Animal research laboratory at a university medical center.. Pigs were randomized to receive a constant infusion of iloprost (0.18 microg/kg/min) or an equivalent amount of carrier solution (normal saline) 30 mins before being infused with endotoxin (100 microg/kg over 1 hr). The infusion with iloprost or carrier solution was continued for the duration of the experiment.. Twelve pigs (six per group), weighing between 20 and 22 kg, underwent laparotomy during which a magnetic flowprobe was placed around the superior mesenteric artery and an ileal tonometer was inserted. Thirty minutes before they were infused with endotoxin, the animals were randomized to receive intravenous iloprost or normal saline. Endotoxin was infused centrally over a 60-min period. Animals received normal saline at a rate of 1.2 mL/kg/min which was begun at the start of the endotoxin infusion. Data were measured at the end of the endotoxin infusion (E60) and 1 hr later (E120). Mean arterial pressure was not affected by the dosage of iloprost used in this experiment. After resuscitation, the cardiac output returned to baseline in the iloprost-treated group but remained decreased in the control group (2.6 +/- 0.5 vs. 1.6 +/- 0.4 L/min). Superior mesenteric blood flow increased 34% above baseline levels in animals pretreated with iloprost (from 363 +/- 85 to 485 +/- 81 mL/min). The superior mesenteric PCO2 was significantly higher (53 +/- 9 vs. 40 +/- 5 torr; 7.1 +/- 1.2 vs. 5.3 +/- 0.7 kPa) and the ileal intramucosal pH was significantly lower (7.07 +/- .28 vs. 7.44 +/- .23) in the control group than in the iloprost-treated group.. Pretreatment with intravenous iloprost effectively increased intestinal blood flow in this model of endotoxin-induced mesenteric ischemia. This action of the drug resulted in an attenuation of ileal intracellular acidosis. Since low-dose iloprost had no effect on mean arterial pressure, it may be a useful adjunct in the treatment of sepsis and septic shock.

Topics: Acidosis; Animals; Endotoxemia; Evaluation Studies as Topic; Hemodynamics; Iloprost; Intestines; Ischemia; Prospective Studies; Random Allocation; Splanchnic Circulation; Swine; Vasodilator Agents