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J Appl Physiol (January 29, 2009). doi:10.1152/japplphysiol.91407.2008
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Submitted on October 23, 2008
Revised on December 25, 2008
Accepted on January 22, 2009

Phosphodiesterase-5 Inhibitors Oppose Hyperoxic Vasoconstriction and Accelerate Seizure Development in Rats Exposed to Hyperbaric Oxygen

Ivan T. Demchenko1, Alex Ruehle2, Barry W. Allen3, Richard D. Vann4, and Claude A. Piantadosi1*

1 Duke University
2 University of Denver
3 Duke University Medical Center
4 Duke Medical University, North Carolina, USA

* To whom correspondence should be addressed. E-mail: piant001{at}mc.duke.edu.

Oxygen is a potent cerebral vasoconstrictor, but excessive exposure to hyperbaric oxygen (HBO2) can reverse this vasoconstriction by stimulating brain nitric oxide (NO) production, which increases cerebral blood flow (CBF)-a predictor of O2 convulsions. We tested the hypothesis that phosphodiesterase-5 (PDE-5) blockers, specifically sildenafil and tadalafil, increase CBF in HBO2 and accelerate seizure development. To estimate changes in cerebrovascular responses to hyperoxia, CBF was measured by hydrogen clearance in anesthetized rats, either controls or those pretreated with one of these blockers, with the NO inhibitor N{omega}-nitro-L-arginine methyl ester (L-NAME), with the NO donor S-nitroso-N- acetylpenicillamine (SNAP); or a blocker combined with L-NAME. Animals were exposed to 30% O2 at 1 ATA ('air') or to 100% O2 at 4 or 6 ATA. EEG spikes indicated CNS oxygen toxicity. The effects of PDE-5 blockade varied as a positive function of ambient PO2. In air, CBF did not increase significantly, except after pretreatment with SNAP. However at 6 ATA O2, mean values for CBF increased and for seizure latency decreased, both significantly; pretreatment with L-NAME abolished these effects. Conscious rats treated with sildenafil before HBO2 were also more susceptible to CNS O2 toxicity, as demonstrated by significantly shortened convulsive latency. Decreases in rCBF reflect net vasoconstriction in the brain regions studied, since mean arterial pressures remained constant or increased throughout. Thus, PDE-5 blockers oppose the protective vasoconstriction that is the initial response to hyperbaric hyperoxia, decreasing the safety of HBO2 by hastening onset of CNS O2 toxicity.







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