|
|
||||||||
Departments of Anesthesia, Medicine, Physiology, and Cardiovascular Research Institute, University of California, San Francisco, California 94143-0542; and Cetus Corporation, Emeryville, California 94608
Received 23 May 1994; accepted in final form 21 May 1996.
Jerome, E. Heidi, Keiji Enzan, Dominique Douguet, Dachuan
Lei, Gary Jesmok, Carol W. Johnson, Maritza Neuburger, and Norman C. Staub. Chronic interleukin-2 treatment in awake sheep causes minimal or no injury to the lung microvascular barrier.
J. Appl. Physiol. 81(4):
1730-1738, 1996.
Interleukin-2 (IL-2) is reputed to
cause a "vascular leak syndrome." We studied pulmonary
hemodynamics and lymph dynamics in six sheep treated for 7 days with
IL-2 (1.8 million IU/kg twice daily or 1.8 million IU/kg each day as a
continuous infusion). Lung lymph flow increased from 4.8 ± 2 ml/15
min pre-IL-2 to 14.4 ± 6.8 ml/15 min on the seventh day of IL-2.
The lymph-to-plasma protein concentration ratio was unchanged (0.70 ± 0.06 vs. 0.63 ± 0.13). The plasma-to-lymph equilibration
half-time of radiolabeled albumin was 2.0 ± 0.6 h pre-IL-2 and 1.0 ± 0.7 h on day 7 of IL-2. Pulmonary arterial pressure was 24 ± 7 cmH2O pre-IL-2, increased to 32 ± 4 cmH2O on the fourth day of
IL-2, and returned to 29 ± 5 cmH2O on the seventh day of IL-2.
Extravascular lung water was normal (4.07 ± 0.25 g/g dry lung). To
clearly determine whether the increase in lung lymph flow was due to
hemodynamic changes or to increased leakiness of the microvascular
barrier, we volume loaded six sheep with lactated Ringer solution
before and after 3 days of IL-2 treatment (1.8 million IU/kg twice
daily). Lung lymph flows increased fivefold during 4 h of crystalloid
infusion compared with baseline and were higher after 3 days of IL-2.
However, lymph-to-plasma protein concentration ratios decreased to the same low levels pre- and post-IL-2 (0.39 ± 0.06 vs. 0.41 ± 0.10), indicating an intact microvascular barrier. Extravascular lung water was elevated (5.56 ± 0.39 g/g dry lung) but was not different from lung water in three volume-loaded control sheep (4.87 ± 0.53 g/g dry lung). We conclude that IL-2 causes minimal or no injury to the
pulmonary microvascular barrier and that volume expansion during IL-2
treatment can cause hydrostatic pulmonary edema.
pulmonary edema; pulmonary circulation; lung injury
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |