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Division of Pulmonary and Critical Care Medicine, Mount Sinai Medical Center, University of Miami School of Medicine, Miami Beach, Florida 33140
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ABSTRACT |
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We tested the hypothesis that atopy and/or
allergic lung inflammation enhances
1-adrenoceptor-mediated
contractions of the bronchial artery. Bronchial arterial resistance
vessels were isolated from rabbits that had undergone either systemic
ovalbumin (OVA) sensitization followed by saline aerosol challenge
(OVA/saline rabbits), or OVA sensitization followed by OVA aerosol
challenge (OVA/OVA rabbits), or no sensitization followed by saline
aerosol challenge (control rabbits). In OVA/OVA rabbits,
bronchoalveolar lavage and lung histology revealed lymphocytic and
eosinophilic inflammation. Arterial rings were contracted with
phenylephrine (PE). In endothelium-intact arteries isolated from
OVA/saline and OVA/OVA rabbits, PE responsiveness was enhanced compared
with that of arteries isolated from controls. The nitric oxide synthase (NOS) inhibitor
NG-nitro-L-arginine
methyl ester increased the contractile response to PE in all three
experimental groups to a similar degree, suggesting that depressed NOS
activity was not involved in the enhanced PE responsiveness in
OVA/saline and OVA/OVA rabbits. After endothelium removal, arteries
from OVA/saline and control rabbits showed similar PE responsiveness,
indicating that the enhancement of PE responsiveness was endothelium
dependent, possibly due to an endothelial constricting factor. In
OVA/OVA rabbits, endothelium-denuded arteries showed decreased PE
responsiveness compared with the other two groups; this difference was
abolished by
NG-nitro-L-arginine
methyl ester. We conclude that systemic sensitization with OVA per se
enhances PE-induced contractions of isolated bronchial arteries in
rabbits by an endothelium-dependent mechanism and that allergic lung
inflammation attenuates this effect by increased nonendothelial NOS activity.
allergy; bronchoalveolar lavage; endothelium; nitric oxide; vasoconstriction
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INTRODUCTION |
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VASCULAR CONGESTION and edema and increased vascularity
have been observed in the bronchi of patients with asthma and
attributed to the effects of inflammatory mediators (9,
27). Asthmatic subjects have been shown to exhibit airway
smooth muscle hyperresponsiveness to
-adrenergic
agonists. In atopic asthmatic subjects, antigen challenge
potentiates
-adrenergic airway smooth muscle
hyperresponsiveness, a phenomenon that can last several
weeks (26). The hyperresponsiveness to
-adrenergic agonists seems to
be associated with changes in the number of
1- and
2-adrenoceptors (ARs), and the
responses to the activation of these receptors seem to be abnormal (4, 24). It is therefore possible that bronchial vascular smooth muscle
also exhibits hyperresponsiveness to
-adrenergic agonists. This
could be considered an adaptation to inflammatory vasodilatation and
hypervascularity in the airway.
In the normal bronchus, norepinephrine released from adrenergic nerves
is an important local regulator of vascular smooth muscle tone, and the
activation of
-ARs in the bronchial circulation in vivo by
-adrenergic agonists has been shown to decrease bronchial arterial
blood flow and increase bronchovascular resistance (3, 22).
In the last decade, the development of new techniques has allowed
pharmacological investigation of small arteries in vitro, and we have
been the first to perform contraction experiments on isolated rabbit
bronchial arteries (28). We found that norepinephrine-induced contraction was mediated through activation of
1- and
2-ARs on both vascular smooth
muscle and endothelium. Direct activation of the
1- and
2-ARs on vascular smooth muscle
caused contraction, whereas activation of endothelial
1- and
2-ARs relaxed vascular smooth
muscle through the release of nitric oxide (NO;
1-AR) and a prostanoid
(
2-AR).
The aim of the study was to use the isolated bronchial artery
preparation to determine whether the contractile response to phenylephrine (PE;
1-AR
agonist) is altered in ovalbumin (OVA)-sensitized rabbits with or
without subsequent OVA aerosol challenge. The study was based on the
premise that OVA sensitization (atopy) and OVA sensitization followed
by OVA aerosol challenge (allergic lung inflammation) have differential
effects on
1-adrenergic-induced contraction of vascular smooth muscle.
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METHODS |
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OVA sensitization and challenge. New Zealand female albino rabbits (weight 6-8 lb.) were sensitized by subcutaneous injection of 1 ml of an OVA-containing emulsion (2.5 mg OVA in 1 part physiological saline and 1 part of Freund's complete adjuvant). After 4 wk the injection was repeated. The experiments were carried out 2-4 wk later. Twenty-four hours before euthanasia, one group of rabbits received an aerosol challenge with a 5% solution of OVA in physiological saline (OVA/OVA). Another group of OVA-sensitized rabbits received an aerosol challenge with saline only (OVA/saline). A third group of rabbits was not sensitized but challenged with a saline aerosol before euthanasia (control). For the aerosol challenge, the rabbits were placed in a closed Plexiglas chamber (18 × 21 × 22 cm). One side of the chamber had an opening for tubing connected to a nebulizer (Raindrop, Puritan-Bennett, producing droplets with a mass median aerodynamic diameter of 3.6 µm); the other side of the chamber had an opening (1 × 22 cm) for air exchange. The nebulizer was connected to a compressed air source and regulated at a flow rate of 8 l/min. At this setting, 3 ml of solution were nebulized during a 20-min exposure time.
Bronchoalveolar lavage (BAL) and lung histology. BAL and lung histology were performed to assess the inflammatory cell status of the rabbit airway and to document lung inflamation in OVA/OVA rabbits. After euthanasia by an overdose of pentobarbital sodium, a plastic catheter (28 cm in length and 1.0 mm in ID) was inserted via a tracheostomy into the trachea of the rabbit as far as the tube was moving freely. BAL was performed by slowly injecting and aspirating three 5-ml aliquots of HEPES solution (in mM: 140 NaCl, 5 KCl, 1 MgCl2, 10 glucose, and 10 hydroxyethylpiperazine-N'-2-ethanesulfonic acid; pH 7.4) at room temperature by using a 5-ml syringe connected to the catheter. The BAL return was collected into a test tube placed on ice. Mean BAL return averaged between 58 and 76% of instilled volume. The effluent collected from the BAL was strained through gauze to remove mucus and centrifuged at 420 g for 10 min at 4°C. The supernatant was decanted, and the cells were resuspended in HEPES solution. An aliquot of this resuspension was transferred to a hemocytometer chamber for cell counting. The number of viable cells was estimated by trypan blue exclusion. A second aliquot of the cell suspension was spun in a cytospin (600 rpm for 10 min) and stained by Diff-Quick (Baxter, Scientific Products) to identify cell populations. For differential cell counts, 500 cells per slide were identified (×100, oil objective). Cell categories included epithelial cells, macrophages, lymphocytes, neutrophils, basophils, eosinophils, and monocytes; unidentifiable cells were grouped into a category termed "other."
Immediately after BAL, representative tissue samples were obtained from both lungs for histological assessment. Three to five specimens were taken from each lung to include intrapulmonary bronchi with different calibers extending to the subpleural areas. The samples were immediately fixed in 10% Formalin in phosphate buffer, embedded in paraffin, sectioned at 4 µm, stained with hematoxylin and eosin, and examined in a blinded manner. The tissue sections were viewed with a BH2 Olympus light microscope equipped with differential interference contrast optics by using a calibrated eyepiece grid (10 × 10 squares) and ×20 objective (total area 1,600 µm2). The number and distribution of polymorphonuclear leukocytes, lymphocytes, and eosinophils were assessed in the bronchial wall, lung parenchyma, and subpleural areas. Three fields of the three to five samples of each lobe were examined in five animals per experimental group. All the fields from a given animal were averaged and considered representative of that particular animal. Lung histology data were obtained in five animals per experimental group.Bronchial artery contractions. After BAL, bronchial artery rings were obtained as described previously (28). Small branches of the bronchial artery measuring 150-350 µm in diameter were isolated, cleaned of connective tissue, and cut into 2-mm-long pieces. Isometric contraction of the arterial rings was assessed in a myograph setup. One bronchial artery ring per rabbit was used for the experiments. For the functional studies, the arterial ring was fixed by two tungsten wires (20 µM) by using a previously described system (29). The rings were given a preload of 150-200 mg. The exact preload was chosen as the tension that produced maximal contraction with a 72.5 mM K+ solution.
In some experiments, the endothelium of the bronchial artery was removed by rubbing the luminal surface of the vessel with a human hair. We have previously demonstrated that functionally this method successfully removes the endothelium in this preparation (28). Dose-dependent contractions induced by PE were obtained by adding PE cumulatively in increasing concentrations. The contraction was expressed as percentage of the contraction induced by isotonic KCl (72.5 mM) solution (maximal contraction). The values of 72.5 mM KCl-induced contractions in six different conditions were not statistically different (NS): control rabbit, intact artery (1,246 ± 148 mg; n = 9) and denuded artery (853 ± 150 mg; n = 9); OVA/saline rabbit, intact artery (1,178 ± 150 mg; n = 9) and denuded artery (955 ± 150 mg; n = 9); OVA/OVA rabbit, intact artery (1,208 ± 124 mg; n = 13) and denuded artery (876 ± 123 mg; n = 13). In the same preparation and under control conditions, two subsequent dose-response curves (DRCs) for PE were reproducible; therefore, in experiments involving NG-nitro-L-arginine methyl ester [L-NAME; NO synthase (NOS) inhibitor], the first DRC in the absence of L-NAME served as control for the second DRC in the presence of L-NAME. The L-NAME (10 µM) concentration used in this study was based on our previous observation that this concentration produces a maximal potentiation of PE-induced contraction in this preparation (28). PE concentration at half-maximal contraction (EC50) and maximal contraction expressed as percentage of the contraction induced by 72.5 mM KCl (Emax) were determined. In some cases the DRC for PE did not level off, and thus the determination of Emax and EC50 was not feasible. Therefore, for the same experimental set of contraction data, the n values (number of rabbits) in Figs. 3 and 4 are higher than the n values for EC50 and Emax. HEPES was used as the normal incubation solution. When solutions with higher extracellular K+ concentration were used, the extra KCl was subtracted from the concentration of NaCl to maintain the osmomolarity and Cl
concentration.
Drugs. The following drugs were used: OVA and Freund's complete adjuvant (Sigma Chemical, St. Louis, MO) and L-NAME and PE (Research Biochemicals International, Natick, MA).
Statistical analysis. For comparisons to baseline values within a group, statistical analysis was performed either by independent tests or by paired Student's t-tests. For comparisons among the three groups, ANOVA was used. After significant differences were found among the three groups, a paired comparison of OVA/saline and OVA/OVA groups with the control groups was tested by Dunnett's test. P < 0.05 was considered as significant. The data were expressed as means ± SE, unless stated otherwise.
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RESULTS |
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Inflammatory cell influx. To characterize the stage of inflammation in the airways and lung tissue, cell counts of inflammatory cells in BAL and histological lungs slices were performed.
The total cell numbers in BAL were similar in control, OVA/saline, and OVA/OVA rabbits, and the cell profiles were similar in control and OVA/saline rabbits (Table 1, Fig. 1). In OVA/OVA rabbits, the percentage of macrophages was diminished and the percentage of lymphocytes and eosinophils was increased. Collectively, lymphocytes and eosinophils constituted 9 ± 3% of the total cell count in controls, 8 ± 2% in OVA/saline rabbits (P = NS vs. control), and 37 ± 5% in OVA/OVA rabbits (P < 0.001 vs. control).
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PE-induced contractions of bronchial artery.
In intact arteries from OVA/saline and OVA/OVA rabbits, the DRC for
PE-induced contractions was shifted to the left (indicating enhanced PE
responsiveness) compared with intact arteries from control rabbits
(Fig. 3). The
EC50 value was significantly lower in OVA/OVA rabbits than in controls, whereas the
Emax was not significantly higher;
in OVA/saline rabbits, the slight differences in the PE-induced
contractility were not found to be statistically different from those
of the control rabbits (Table
2). In intact arteries,
L-NAME (10 µM) increased the
response to PE in all three experimental groups (Fig. 3). In control
rabbits, L-NAME induced a small
shift in the EC50 value and a
significant potentiation of Emax
to 77 ± 14% (Table 2). In OVA/saline and OVA/OVA rabbits, L-NAME shifted the
EC50 values to 0.5 ± 0.1 and
0.6 ± 0.1 µM, respectively, and increased the corresponding
Emax values to 117 ± 8% in
OVA/saline and 102 ± 11% in OVA/OVA rabbits. Thus the L-NAME induced potentiation of
PE responsiveness was similar in the three groups of rabbits. However,
in the presence of L-NAME, the
difference in the PE-induced response of OVA/saline and OVA/OVA rabbits
in comparison to control rabbits was further enhanced.
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DISCUSSION |
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BAL and lung histology disclosed lymphocyte and especially eosinophil
recruitment to the lung in OVA/OVA rabbits but not in OVA/saline
rabbits. This is in keeping with earlier observations that, 24 h after
antigen challenge, rabbits exhibit a predominantly eosinophilic lung
inflammation (2, 5, 10, 19, 23). The experiments in intact arteries
demonstrated that OVA sensitization, especially with subsequent OVA
aerosol challenge, slightly enhanced the contractile sensitivity to PE.
L-NAME increased the contractile sensitivity to PE in all three experimental groups, confirming our
earlier observations that NO was released during
1-AR activation (28). However,
L-NAME did not eliminate, but
enhanced, the difference in PE responsiveness between sensitized
(OVA/saline and OVA/OVA) and nonsensitized (control) rabbits. This
indicates that the potentiation of PE contraction by OVA sensitization
and OVA sensitization plus OVA aerosol challenge was not due to a
downregulation of NOS. Endothelium removal abolished the enhanced PE
responsiveness of arteries from OVA/saline rabbits in comparison to
control rabbits. This suggests that the OVA sensitization-induced
upregulation of PE responsiveness was mediated by the endothelium.
Surprisingly, the response to PE was diminished in endothelium-denuded arteries from OVA/OVA rabbits. In the presence of L-NAME, the PE responsiveness of arteries from these rabbits was enhanced back to the level of the other two groups.
Taken together, these results indicate that
1) the response to PE is increased
by systemic OVA sensitization; 2)
this effect is endothelium dependent but does not involve a depressed
NOS activity; and 3) allergic
inflammation in the lung induced by OVA aerosol challenge in
OVA-sensitized rabbits causes endothelium-independent attenuation of
the PE-induced response, suggesting a NO synthase activation in
vascular smooth muscle cells. We have previously shown that
1-AR activation causes NO
release from endothelium in rabbit bronchial artery (28). This was
confirmed in the present study in which
L-NAME failed to potentiate PE
responsiveness in endothelium-denuded arteries from control rabbits. We
therefore believe that the
L-NAME sensitive downregulation
of PE responsiveness in endothelium-denuded arteries from OVA/OVA
rabbits was due either to the appearance of
1-AR-dependent NOS activity or
1-AR-independent NOS activity
in vascular smooth muscle. Irrespective of the underlying mechanisms,
an atopy potentiates
1-AR-
mediated contraction of rabbit bronchial arteries, and allergic
inflammation blunts the effects of an atopy.
Effect of systemic OVA sensitization.
The immunologic mechanisms whereby systemic sensitization to OVA
increased PE-induced contractions of the bronchial artery are not
known. It may reflect a generalized systemic hyperresponsiveness to PE.
Earlier studies have shown that inflammation in general can increase
the vascular response to
1-activation (12, 13, 25) and
that in allergic asthma the superficial dermal blood vessels are also
affected (25). Systemic OVA sensitization has been shown to induce
hypersensitivity to norepinephrine in isolated dog pulmonary arteries
(14).
1-AR activation was endothelium
dependent. Endothelium is known to release a variety of smooth
muscle-relaxing and -contracting factors. Theoretically,
there would be two ways whereby sensitization could cause
endothelium-dependent differences in the contractile response to PE:
1) by inhibiting the release of
relaxing factors or 2) by releasing
contractile factors. In rabbit bronchial artery, the major
endothelium-derived relaxing factor released by
1-AR activation is NO (28).
However, in the present study, the response of sensitized intact
arteries to PE in OVA-sensitized rabbits was further enhanced by
L-NAME, thereby excluding
diminished NOS activity as the cause of the increased contractile
responsiveness. Therefore, it is more plausible that the
OVA-sensitization-induced increase in PE responsiveness could be due to
one or more endothelium-derived contractile factors.
Endothelial cells can be activated by several stimuli, including
cytokines, which seem to play pivotal roles in the control of vascular
tone and structure. For example, interleukin (IL)-1 and tumor necrosis
factor (TNF) have been shown to increase endothelin-1 (ET-1) mRNA
expression and ET-1- secretion (8, 17, 20). Increased endothelin levels
in BAL have been reported in patients with asthma (16, 18). Other known
endothelium-derived contractile factors could also be involved (e.g.,
cycloxygenase, lipoxygenase, and phospholipase D products). The
identification of putative endothelium-derived contractile factors will
be the object of future studies.
The mechanism whereby systemic sensitization induces the
-AR
hyperresponsiveness is not known. Systemic sensitization has been
reported to alter the mechanical properties of both airway and
pulmonary arteries and veins to histamine in dogs (1, 15). However, our
findings provide the first evidence that sensitization might not,
against earlier beliefs, have a direct effect on the mechanical
properties of the vascular smooth muscle but rather exhibits its
influence through functional changes in endothelium. In the present
study, the cell differentiation data in BAL and lung histology in
OVA/saline rabbits did not differ significantly from the control
rabbits, suggesting that the hyperresponsiveness to PE-induced effect
was not dependent an increased number of inflammatory cells in the lung
at the time of assessment.
Allergic lung inflammation.
In OVA/OVA rabbits, the presence of allergic lung inflammation was
demonstrated by increased numbers of lymphocytes and eosinophils in BAL
and lung histology. In endothelium-denuded arteries of these rabbits,
antigen challenge produced a diminished PE responsiveness, and this
appeared to be due to increased NOS activity. Several studies have
demonstrated that cultured vascular smooth muscle can produce NO in
inflammation mimicking conditions and thus regulate the contractile
sensitivity to other mediators. For example, cytokines such as IL-6,
IL-1, and TNF are known to activate the synthesis of NO and/or
prostacyclin in various vascular smooth muscle cells and attenuate the
contractile sensitivity to
1-AR
activation (6, 11, 21). There is increasing evidence that NO synthesis is enhanced in a variety of diseases, asthmatic inflammation included, and several classical signs of inflammation are reversed by NOS inhibitors (7). NO is synthesized by a family of NOS, which are either
constitutive and calcium dependent (cNOS; e.g., neurons, endothelium)
or inducible and calcium independent (iNOS; e.g., macrophages,
fibroblasts, smooth muscle cells, neutrophils). cNOSs respond to
receptor stimulation and produce small amount of NO, whereas iNOSs
respond to a variety of inflammatory factors and produce NO in large
amounts. L-NAME, which was used
for blocking NOS in this study, is a nonselective inhibitor of NOS and
blocks both cNOS and iNOS. Thus the augmented NOS activity in our
OVA/OVA rabbits may have involved either NOS in vascular smooth muscle cells.
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ACKNOWLEDGEMENTS |
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We thank Noe Tachoronte for excellent technical assistance.
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FOOTNOTES |
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This study was supported by National Heart, Lung, and Blood Institute Grant HL-58086.
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact.
Address for reprint requests and other correspondence: A. O. A. Zschauer, Div. of Pulmonary and Critical Care Medicine, University of Miami, P.O. Box 016960 (R-47), Miami, FL 33101 (E-mail: azschaue{at}med.miami.edu).
Received 5 May 1998; accepted in final form 29 December 1998.
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