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Biomedical subjects

V M Miller

Publications and source records attributed to V M Miller.

At least 19 recordsLinked to original sources

Distribution of endothelin-1 in transplanted human lungs.

BACKGROUND: This study was designed to assess which cells in transplanted lungs express endothelin-1 (ET-1) and if expression of the peptide can be used to discriminate between rejection and infection in transplanted lungs. METHODS: Transbronchial biopsies (n=104) from 29 human lung transplant recipients were stained immunohistochemically for ET-1. Cells expressing ET-1 (pneumocytes, endothelial cells, airway epithelial cells, lymphocytes, and macrophages) were quantified and correlated with clinical histopathology findings. RESULTS: ET-1 was expressed in airway epithelial cells (93% of the biopsies), infiltrating macrophages (86%), and lymphocytes (19%) but not in endothelial cells or pneumocytes. ET-1 expression did not vary with rejection, obliterative bronchiolitis, or infection. ET-1 expression did not correlate with age, grade of rejection, pulmonary function, or time after transplantation. CONCLUSION: In transplanted human lungs, ET-1 is expressed in airway epithelial cells and infiltrating macrophages, and expression does not vary with pathological processes. Therefore, immunostaining for ET-1 probably cannot be used to discriminate between rejection and infection in transplanted lungs.

Acute Disease

Alterations in mRNA for inducible and endothelial nitric oxide synthase and plasma nitric oxide with rejection and/or infection of allotransplanted lungs.

BACKGROUND: Experiments were designed to determine expression of type II (iNOS) and type III (ecNOS) nitric oxide synthase in lung parenchyma and systemic endothelial cells with rejection and/or infection of single lung allografts. METHODS: After single lung allotransplantation, dogs were maintained on standard triple immunosuppressive therapy for 5 days and then placed into one of three groups. Group I (n=4) was maintained on immunosuppressants, group II (n=7) immunosuppression was withdrawn to allow acute rejection of the allograft, and group III (n=6) infection was induced by bronchoscopic inoculation of Escherichia coli. RESULTS: At postoperative days 7-9, no histological evidence of rejection or infection was observed in transplanted lungs of group I. In lungs of group II, rejection ranged from mild to severe; in lungs of group III, infection was severe. Some animals had both rejection and infection (n=8) and were studied separately. Plasma levels of nitric oxide increased comparably with rejection and/or infection compared to preoperative values. Expression of mRNA for ecNOS decreased significantly in lung parenchyma but not in aortic endothelial cells from dogs of groups II and III. However, expression of mRNA for iNOS increased with both rejection and/or infection in both lung parenchyma and aortic endothelial cells. CONCLUSIONS: iNOS is induced locally within the graft and systemically in aortic endothelial cells with rejection and/or infection of lung allografts. Plasma levels of nitric oxide are elevated with both rejection and infection and may not be useful in the differential diagnosis of these processes after lung transplantation.

Animals

The effect of estrogen replacement therapy on plasma nitric oxide and endothelin-1 levels in postmenopausal women.

BACKGROUND: Estrogen replacement therapy (ERT) in postmenopausal women decreases cardiac mortality and improves endothelial function. The endothelium regulates vascular tone and growth by releasing such factors as nitric oxide and endothelin-1. OBJECTIVE: To determine whether ERT alters the balance between the total oxidized products of nitric oxide and endothelin-1. DESIGN: Single-arm, before-after clinical trial. SETTING: Outpatient clinical research center of an academic medical center. PATIENTS: 15 postmenopausal women. INTERVENTION: Treatment with 17 beta-estradiol for 6 months and a 10-day course of methoxyprogesterone every 3 months. MEASUREMENTS: Plasma nitric oxide and endothelin-1 levels were measured at baseline and after 6 months of ERT. RESULTS: The mean baseline nitric oxide level was 27.5 nmol/mL (range, 20.3 to 34.8 nmol/mL) and increased by a mean of 7.2 nmol/mL (range, 0.2 to 14.1 nmol/mL) (P = 0.04). The mean baseline plasma endothelin-1 level was 16.4 pg/mL (range, 12.0 to 20.8 pg/mL) and decreased by a mean of 3.9 pg/mL (range, 0.4 to 7.8 pg/mL) (P = 0.04). The mean baseline ratio of nitric oxide to endothelin-1 was 2.0 (range, 1.3 to 2.8) and increased by 1.2 (range, 0.1 to 2.2) (P = 0.03). CONCLUSION: ERT results in an increased ratio of nitric oxide to endothelin-1. This may be one mechanism by which ERT provides cardiovascular benefit.

Aged

Plasma nitric oxide before and after smoking cessation with nicotine nasal spray.

Nicotine may affect cardiovascular function through release of neurotransmitters from autonomic nerves or release of vasoactive substances from the vascular endothelium. Nitric oxide is a neurotransmitter and endothelium-derived factor that reduces tone of vascular smooth muscle. Experiments were designed to determine whether or not use of nicotine nasal spray for smoking cessation affects plasma levels of nitric oxide. Forty smokers self-administered nicotine by nasal spray (one 0.5 mg spray to each nostril). Blood samples were taken before the use of the nasal spray and at treatment day 7 for the measurement of cotinine by high pressure liquid chromatography and nitric oxide (NOx) by chemiluminescence. Age-comparable controls were never-smokers nonnicotine users recruited from laboratory personnel. Mean plasma concentrations of NOx from smokers before treatment were significantly greater compared with nonsmokers (23 +/- 10, n = 40 and 15 +/- 6, n = 13 nmoles/mL [mean +/- SD], respectively, P < 0.01). Plasma NOx in smokers was not significantly correlated with the average daily number of cigarettes smoked (r2 = 0.02, P > 0.05) but was positively and linearly correlated with plasma cotinine (r2 = 0.13, P < 0.02). In 32 self-reported abstinent smokers (confirmed by expired carbon monoxide < 9 ppm) using nicotine nasal spray, cotinine decreased by 64% from pretreatment levels of 284 +/- 103 to posttreatment levels of 90 +/- 58 ng/mL. Plasma NOx was unchanged and went from 23.0 +/- 10.1 at pretreatment to 21 +/- 12 nmoles/mL with nicotine treatment. These results suggest that nicotine-use, independent of cigarette smoking, affects plasma NOx.

Administration, Intranasal

Transbronchial gene transfer of endothelial nitric oxide synthase to transplanted lungs.

BACKGROUND: Experiments were designed to study the efficiency, distribution, and toxicity of transbronchial adenoviral-mediated transfer of endothelial constitutive nitric oxide synthase (ecNOS) gene to transplanted lungs. METHODS: Syngeneic orthotopic single-lung transplantation in the rat was performed after airway administration (300 microL, 1 x 10(9) pfu/mL) of either the ecNOS gene or the marker gene beta-Gal (control group) to donor lungs (n=4 each). After 4 days, transgene expression, inflammation, and the presence of apoptosis in the transplanted lungs were assessed by molecular, immunohistochemical, and histologic techniques. RESULTS: Gene transfer was confirmed by a positive polymerase chain reaction signal for the recombinant ecNOS gene, and recombinant messenger RNA by reverse transcription polymerase chain reaction. Positive immunohistochemical staining for ecNOS was present in more than 75% of pneumocytes only in ecNOS transduced lungs. Calcium-dependent nitric oxide synthase activity was increased in ecNOS- compared with betaGal-transduced lungs (2,139+/-756 versus 47+/-28 pmol x mg protein(-1) x h(-1); p < 0.05). Minimal to mild inflammation was observed in all transplanted lungs; fewer than 0.5% of cells in both groups were apoptotic. CONCLUSIONS: Transbronchial transfer of ecNOS gene to the transplanted lung results in transduction of pneumocytes with expression of a functionally active transgene product.

Adenoviridae

Endothelial sodding of the Permaflow prosthetic coronary artery bypass conduit.

BACKGROUND: Experiments were designed to determine the feasibility of sodding an endothelial monolayer within the lumen of a prosthetic conduit applied to the canine coronary circulation. METHODS: Autologous endothelial cells were sodded onto the luminal surface of the Permaflow conduit and immediately implanted to bypass the left circumflex coronary artery in adult mongrel dogs (n = 9). Unsodded Permaflow conduits were implanted as controls (n = 8). At 3 weeks, grafts were explanted and examined by scanning electron microscopy and immunostained for canine von Willebrand factor. RESULTS: Sodded grafts contained a confluent endothelial cell layer devoid of adherent thrombus or platelets and stained positively for canine von Willebrand factor. Unsodded grafts contained no endothelium and retained adherent platelets, collagen, and fibrin. Effluent from sodded grafts stimulated with calcium ionophore A23187 caused a significantly greater relaxation of its bioassay ring than effluent from unsodded grafts (60%+/-21% versus 12%+/-5%; n = 8, p < 0.03). CONCLUSIONS: Sodding of endothelial cells onto a Permaflow coronary artery bypass graft results in a confluent, viable, nonthrombogenic, endothelial monolayer and releases vasodilator substances in response to calcium ionophore A23187. Endothelial sodding may optimize prosthetic grafts.

Animals

Effects of thrombolysis and venous thrombectomy on valvular competence, thrombogenicity, venous wall morphology, and function.

PURPOSE: The experiments were designed to compare the effects of thrombolytic therapy (TL) and balloon-catheter thrombectomy (TX) on valvular competence, thrombogenicity, venous wall morphology, and function after acute deep venous thrombosis (DVT) in canine veins. METHODS: The femoral veins of male mongrel dogs were ligated proximally and distally for 48 hours to induce DVT. The thrombosed veins were treated with either TL (n = 5) or TX (n = 9), or no treatment was rendered (n = 6). Sham-operated dogs were used as controls. TL was performed with catheter-directed infusion of urokinase at 4000 U/min for 90 minutes. Three hours after the treatment, the valvular competence was determined with duplex scanning, thrombogenicity determined with deposition of radio-labeled platelet and fibrin, and function determined with response to contractile and relaxing agonists in organ chambers. The structural integrity of the endothelial layer was assessed by means of scanning electron microscopy. RESULTS: The removal or lysis of the thrombus was successful in all cases. The valvular competence did not differ among the groups. The platelet deposition was the highest after TX (P <.05), and the fibrin deposition was not significantly different among the groups. In the organ chamber experiments, relaxations to adenosine diphosphate and nitric oxide were reduced after TX (P <.05). The contractions to serotonin were enhanced after TX. Scanning electron microscopy results showed a comparable (51% to 75%) endothelial loss with either treatment. CONCLUSIONS: After experimental acute DVT, the TL and the TX at 3 hours had similar effects on the valvular competence and the endothelial morphology. However, the TL reduced thrombogenicity, which is consistent with the preserved endothelial responses to platelet products. These data suggest that TL may preserve vein function after DVT and may reduce the long-term potential for recurrent DVT and post-thrombotic syndrome.

Animals

Functional changes in nonadrenergic, noncholinergic inhibitory neurons in ileal circular smooth muscle after small bowel transplantation in rats.

This experiment was designed to determine mechanisms of change in nonadrenergic, noncholinergic (NANC) inhibitory neurons in the ileum after small bowel transplantation (SBT) in the rat and whether nitric oxide (NO) serves as an important NANC inhibitory neurotransmitter in the rat ileum. Eight groups of rats (N > or =8 rats/group) were studied: neurally intact unoperated controls; rats one week after anesthesia and sham celiotomy; and separate groups one and eight weeks after either 40 min of cold ischemia of the jejunoileum, combined jejunal and ileal intestinal transection/reanastomosis, or orthotopic SBT of the entire jejunoileum. Contractile activity was evaluated in full-thickness ileal circular muscle strips under isometric conditions. Spontaneous activity did not differ among groups. In all groups, exogenous NO, NG-monomethyl-L-arginine (L-NMMA, an NO synthase inhibitor), and methylene blue (soluble guanylate cyclase inhibitor) had no effect on spontaneous activity, while 8-bromocyclic guanosine monophosphate (8Br-cGMP) inhibited contractile activity in all groups. Low frequency (2-10 Hz) electrical field stimulation (EFS) inhibited contractile activity only in control and SBT groups; L-NMMA and methylene blue did not alter the response to EFS in any group. These results suggest that each aspect of the SBT procedure, ischemia/reperfusion injury, disruption of enteric neural continuity by intestinal transection, and extrinsic denervation, alter function of enteric ileal inhibitory neurons separately early (one week) after operation. NO, a known inhibitory neurotransmitter in other gut regions, does not affect ileal circular muscle in neurally intact tissue nor mediate functional changes in inhibitory nerve function nor smooth muscle contractility after SBT.

Animals

Gender and relaxation to C-type natriuretic peptide in porcine coronary arteries.

Experiments were designed to determine whether or not relaxations of coronary arterial smooth muscle to C-type natriuretic peptide (CNP) vary according to gender, and if so, to determine mechanisms for the differences. Rings of coronary arteries without endothelium from sexually mature male and female Yorkshire pigs were suspended in organ chambers for measurement of isometric force. Cumulative concentration-responses to CNP (10(-9)-10(-7) M) were obtained in the absence and presence of either K+ channel blockers (charybdotoxin, apamine, or glibenclamide, 10(-7) M) or the clearance-receptor antagonist C-ANP (10(-6) M) during contractions to prostaglandin F2alpha (2 microM). Relaxations to CNP were significantly less in arteries from male compared with female pigs and were significantly attenuated by charybdotoxin and glibenclamide in both sexes. However, apamine reduced relaxations to CNP only in arteries from female pigs. C-ANP significantly potentiated relaxations to CNP only in arteries from male pigs. In separate experiments, cyclic guanosine monophosphate (cGMP) was measured by radioimmunoassay at specified times after the addition of CNP (10(-7) M). Peak increases in cGMP were greater and occurred earlier in arteries from female than from male pigs; these differences were eliminated by the phosphodiesterase inhibitor 3-isobutyl-1-methyl-xanthine (10(-4) M). These results demonstrate three mechanisms that contribute to gender differences in CNP-mediated relaxation of coronary arterial smooth muscle: activation of low conductance Ca2+-activated K+ channels, natriuretic peptide clearance receptors, and activity/regulation of phosphodiesterases.

Animals

Induction and cDNA sequence of inducible nitric oxide synthase from canine aortic smooth muscle cells.

An inducible isoform of nitric oxide synthase (type II, iNOS) is expressed in cardiac and vascular smooth muscle in response to inflammatory cytokines. The dog is an important large animal used for cardiovascular research including effects of exercise, heart failure, and allograft rejection. However, molecular probes for iNOS developed in other mammals have not been reliable for the study of iNOS induction in canine vascular smooth muscle. Experiments were designed to develop a molecular probe for canine iNOS. Smooth muscle cells were isolated from canine aortas. The cells (passages 3-10) were incubated for 1, 3, 6, 12, 24, 48, or 72 h in the absence and presence of Escherichia coli lipopolysaccharide (LPS) to induce iNOS. Total RNA was isolated from the cells using standard techniques. RT-PCR with primers against conserved regions of all known iNOS enzyme was used to clone the iNOS cDNA. RT-PCR showed a single band only from cells treated with LPS. Cloned cDNA from cultured canine aortic smooth muscle cells has 84% homology to human, 81% to rat, and 81% to mouse iNOS gene. Identification of the cDNA for canine iNOS will be useful in the study of differential, transcriptional regulation of inducible (type II) compared with constitutive endothelial (type III) NOS in canine studies of allograft rejection and cardiovascular disease.

Amino Acid Sequence

Treatment with an antioxidant inhibits vascular changes caused by circulating lymphocytes during acute lung rejection in dogs.

BACKGROUND: Experiments were designed to evaluate the effect of treatment with an inhibitor of lipid peroxidation, H 290/51, on the interaction of lymphocytes and pulmonary arteries during acute lung rejection. It was hypothesized that inhibition of lipid peroxidation would reduce contractions of the pulmonary arteries to autogenous rejection-activated lymphocytes. METHODS: Single-lung transplantation was performed in three groups of dogs: group 1 was maintained on immunosuppression for 8 days postoperatively; in group 2, immunosuppression was discontinued on postoperative day 5, so that rejection occurred on postoperative day 8; in group 3, immunosuppression was discontinued after 5 days, and the lipid peroxidation inhibitor H 290/51 was given orally for 3 days. The pulmonary arteries were removed, cut into rings, and suspended in organ chambers for measurement of isometric force. RESULTS: Macrophage-depleted mononuclear cells (MNCs; lymphocytes) isolated from blood caused cell number-dependent contractions in rings of the pulmonary arteries from all dogs. In the rejecting dogs treated with H 290/51 (group 3), contractions to MNCs were significantly greater in rings without endothelium compared to rings with endothelium. Contractions to MNCs with or without endothelium were reduced by adding deteroxamine to the medium but not by adding superoxide dismutase and catalase. CONCLUSIONS: The results of this study show that treatment with a lipid peroxidation inhibitor, H 290/51, does not prevent acute rejection of transplanted lungs. The treatment with the peroxidation inhibitor modifies contractions of the pulmonary arteries in response to rejection-activated lymphocytes, indicating that reactive oxidative metabolites may be involved in the vasoactive response resulting from this interaction.

Animals

Enhanced endothelin-mediated coronary vasoconstriction and attenuated basal nitric oxide activity in experimental hypercholesterolemia.

BACKGROUND: Experimental hypercholesterolemia is associated with coronary vasomotor dysfunction. This study was designed to test the hypothesis that experimental hypercholesterolemia is characterized by altered coronary vasomotor responses to endothelin and inhibition of the endogenous NO pathway. METHODS AND RESULTS: Endothelin-1 (ET-1) at 5 ng x kg(-1) x min(-1) or N(G)-monomethyl-L-arginine (L-NMMA), a competitive inhibitor of nitric oxide synthase (NOS), at 50 microg x kg(-1) x min(-1) was infused into the left anterior descending coronary artery in pigs before and after 10 weeks of cholesterol diet. There was a significant increase in serum cholesterol. At 10 weeks, ET-1 resulted in an accentuated decrease in coronary blood flow (CBF) and coronary artery diameter (CAD) compared with baseline (-88+/-6% versus -45+/-9%, P<.05, and -77+/-14% versus -18+/-8%, P<.05, respectively) and an increase in coronary vascular resistance (CVR) (242+/-18% versus 110+/-17%, P<.05); ET receptor density and binding affinity in epicardial coronary arteries were unchanged. The effect of L-NMMA on CBF, CAD, and CVR was attenuated at 10 weeks (-7+/-8% versus -48+/-4%, -2+/-3% versus -17+/-5%, and 16+/-10% versus 125+/-32%; each P<.05). Immunohistochemistry staining for constitutive NOS revealed a decrease in immunoreactivity in the coronary arteries of hypercholesterolemic pigs. CONCLUSIONS: The present study demonstrates an enhanced coronary vasoconstrictive response to pathophysiological doses of endothelin and an attenuated response to the inhibition of endogenous NO activity, suggesting an alteration in coronary vascular reactivity in experimental hypercholesterolemia.

Acetylcholine

Characteristics of endothelin receptors in acutely rejecting transplanted lungs.

Experiments were designed to characterize endothelin receptors in bronchi and parenchyma of transplanted lungs during acute rejection. Third-order bronchi from autografted or allografted lungs were either cut into rings and suspended in organ chambers for the measurement of isometric force or frozen for isolation of membrane proteins. Lung parenchyma was prepared for histology or isolation of membrane protein. The grade of rejection was 2.74+/-0.17 (n= 19) in allotransplanted lungs; evidence of infection was present in 58% of the transplanted lungs. In organ chamber experiments, endothelin 1 (which stimulates endothelin A receptors) caused comparable contraction of bronchi from autotransplanted and allotransplanted rejecting lungs. Endothelin 3 (which stimulates endothelin A and B receptors) caused contractions of bronchi from autotransplanted lungs which were not different from those caused by endothelin 1. In contrast, contractions caused by endothelin 3 were reduced in bronchi from rejecting allotransplanted lungs. The magnitude of contractions caused by endothelin 3 was reduced further when infection was present with rejection. Competitive inhibition of 125I-endothelin 1 by endothelin 3 was significant for a two-site binding model in membranes prepared from all bronchi and lung parenchyma. The total number of binding sites (Bmax) was reduced significantly in bronchi and parenchyma from rejecting lungs with or without infection. The relative proportions of high-affinity and low-affinity binding sites did not change. Affinities of both high- and low-affinity receptors were not altered with rejection. These results indicate that at least two subtypes of endothelin receptors are present on canine bronchial smooth muscle and parenchyma. The number of endothelin receptors associated with bronchial contractions is reduced with rejection of lung allografts.

Animals

Effects of lung preservation with Euro-Collins and University of Wisconsin solutions on endothelium-dependent relaxations.

BACKGROUND: This study compares the effect of lung preservation using flush perfusion of Euro-Collins or University of Wisconsin solution on the pulmonary vascular function of endothelium-dependent and endothelium-independent relaxations. METHODS: Rings of canine intrapulmonary arteries were studied after 6 hours of cold ischemia in Euro-Collins or University of Wisconsin preservation solution. Endothelium-dependent and endothelium-independent relaxations were induced in organ chamber experiments. To also study pulmonary resistance vessels, endothelium-dependent relaxations were induced in in vitro perfused intact rabbit lungs. RESULTS: In the organ chamber experiments, a moderate but significant (p < 0.05) reduction in endothelium-dependent relaxations were found in the perfused and stored vessels. In perfused rabbit lungs, a decrease in the endothelial response occurred immediately after perfusion with Euro-Collins solution. However, a recovery and overshooting response was found after preservation with either solution and 6 hours of cold ischemia. A significant increase in the sensitivity of smooth muscle cells to nitric oxide was shown in both preparations. CONCLUSIONS: Both crystalloid perfusion fluids cause a decrease in endothelial function during the perfusion procedure. In contrast, endothelial function is well preserved during the ischemic time. University of Wisconsin solution induced a higher sensitivity of the vascular smooth muscle to the endothelium-derived relaxing factor nitric oxide. A reduction in pulmonary vascular resistance after University of Wisconsin preservation may be of importance in subsequent clinical lung transplantation.

Adenosine

Characterization of endothelin receptors in human varicose veins.

PURPOSE: Experiments were designed to characterize endothelin receptors in human varicose veins. Three groups of veins were studied: (1) varicose vein (VV) tributaries of the greater saphenous vein from patients who were undergoing vein stripping for primary varicosity; (2) greater saphenous veins (SVs) from the same patients; and (3) greater saphenous veins from patients without varicosity who were undergoing arterial reconstruction (control). METHODS: Veins were either cut into rings and suspended in organ chambers for measurement of isometric force, prepared for receptor binding of membrane proteins, or were prepared for measurement of preproendothelin mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Endothelin-1 (10(-11) to 10(-7) mol/L) produced similar concentration-dependent contractions in rings with or without endothelium. Maximal tensions were significantly greater in control veins compared with either SVs or VVs. Sarafotoxin S6c (10(-11) to 3 x 10(-7) mol/L), which is selective for the endothelin-B receptor, also produced concentration-dependent increases in tension in all veins. Sarafotoxin S6c responses in VVs were shifted significantly rightward compared with either SVs or control. Maximal tensions to sarafotoxin S6c also were significantly greater in control veins compared with either SVs or VVs. In receptor binding studies, the number of binding sites as defined by competitive inhibition of 125I-endothelin-1 by endothelin-1 was less in VVs than control veins. Competitive inhibition of 125I-endothelin-1 with endothelin-3 (both A and B receptors) or sarafotoxin S6c (B receptors only) suggests that the difference in receptor number between varicose and nonvaricose veins is attributable to differences in the endothelin-B receptor subtype. Binding affinities were not significantly different for either of the receptor subtypes in all veins studied. Preproendothelin mRNA as quantitated by RT-PCR tended to be higher in VVs compared with either SVs or control veins. CONCLUSIONS: Decreased contractions to endothelin-1 in both varicose and saphenous veins of patients with primary varicosity may be associated with a decrease in the number of receptors. These receptors may be downregulated in response to increased production of endothelin-1, which is regulated at the transcriptional level.

Aged

Production of endothelium-derived factors from sodded expanded polytetrafluoroethylene grafts.

PURPOSE: Experiments were designed to determine whether endothelium isolated from adipose tissue and sodded onto expanded polytetrafluoroethylene grafts release endothelium-derived vasoactive factors. METHODS: Thin-walled expanded polytetrafluoroethylene grafts (6 mm internal diameter, 6 cm length, 30 microm pore size), one sodded with autogenous endothelial cells, the other unsodded, were implanted bilaterally in carotid arteries of 30 male mongrel dogs. Dogs were treated with 325 mg aspirin daily. After 6 weeks grafts were excised and perfused in a bioassay system. Effluent from the grafts stimulated with either acetylcholine, thrombin, adenosine 5-diphosphate, or the calcium ionophore A23187 was superfused over rings of canine femoral arteries without endothelium contracted with phenylephrine. Effluent from the grafts was analyzed by radioimmunoassay for thromboxane B2, 6-keto-prostaglandin F1alpha, endothelin-1, and C-type natriuretic peptide. RESULTS: Ninety percent of the sodded grafts and 87% of the unsodded grafts were patent after 6 weeks. Bioassay rings superfused with effluent from sodded grafts stimulated with acetylcholine relaxed significantly more than rings superfused with effluent from similarly stimulated unsodded grafts. Biochemical analysis of the effluent showed an increase in 6-keto prostaglandin F1alpha and C-type natriuretic peptide and a decrease in endothelin-1 and thromboxane B2 release from the sodded compared with the unsodded grafts. Scanning electron microscopy showed a continuous layer of endothelial cells lining only the sodded grafts. Staining for alpha-actin and heavy-chain myosin showed a differentiated layer of smooth muscle below the endothelial layer on the sodded grafts. Finally, there was positive staining for C-type natriuretic peptide and endothelin-1 in the endothelium of the sodded grafts. CONCLUSIONS: These results indicate that endothelial cells of sodded expanded polytetrafluoroethylene grafts produce endothelium-derived vasoactive factors. In addition, receptor-coupled synthesis/release of these factors is retained in sodded endothelial cells.

6-Ketoprostaglandin F1 alpha

An arginine analog inhibits responses of both the endothelium and smooth muscle of canine in situ vein grafts.

Increased shear, pressure, and oxygen tension in vein grafts may alter production of endothelium-derived vasoactive and anti-mitogenic factors such as nitric oxide which subsequently affect development of neointimal hyperplasia. This study was designed to determine whether or not nitric oxide mediates endothelium-dependent responses in femoral in situ vein grafts. Non-reversed, canine femoral vein grafts were placed bilaterally to bypass a ligated segment of the femoral artery in dogs. After 6 weeks, the grafts were removed, cut into rings, and suspended in organ chambers for measurement of isometric force. In some rings the endothelium was removed deliberately. In the presence of indomethacin, the synthetic analog of L-arginine, L-N(G)-monomethyl-arginine (10(-4) M; L-NMMA) did not cause a significant change in baseline tension of rings with endothelium. L-NMMA reduced only contractions of rings with endothelium to the alpha-adrenergic agonist UK 14,304. The analog also reduced maximal relaxations to the calcium-ionophore, A23187 in rings with endothelium. In addition, L-NMMA reduced relaxations of rings without endothelium to adenosine diphosphate by 35%. Positive immunostaining for nitric oxide synthase was present in both the myointima and media of histological sections of grafts. In conclusion, these results suggest that in situ vein grafts exhibit two unique properties which are unlike unoperated arteries or veins: (i) alpha2-adrenergic receptors may be coupled to the release of contractile endothelium-derived factors associated with production of nitric oxide: and (ii) nitric oxide may be released by the smooth muscle in response to purinergic stimulation. The presence of nitric oxide synthase throughout the wall of the graft may result in production of nitric oxide in response to adenosine diphosphate released by platelets and to circulating catecholamines.

Adrenergic alpha-Agonists

Adrenomedullin-mediated relaxations in veins are endothelium-dependent and distinct from arteries.

In arteries, adrenomedullin (ADM) causes relaxations of rings with and without endothelium by stimulating accumulation of cyclic nucleotides resulting from activation of the ADM and calcitonin gene-related peptide (CGRP) receptors. Experiments were designed to determine the mechanism(s) of relaxation to ADM in veins. Rings of canine femoral vein with and without endothelium were suspended in organ chambers for measurement of isometric force. Rings were contracted with prostaglandin F2alpha (2 x 10(-6) M), and cumulative dose-responses to ADM (10(-11) to 10(-7) M) were obtained in the absence or presence of indomethacin (10(-5) M), indomethacin + N(G)-monomethyl-L-arginine (10(-4) M), methylene blue (10(-5) M), particulate guanylate cyclase inhibitor HS-142-1 (10(-5) M), tetraethylammonium (TEA, 10(-2) M), CGRP-receptor antagonist (CGRP 8-37, 10(-6) M), ADM-receptor antagonist (ADM 26-52, 10(-6) M), diphenhydramine (10(-6) M), 8-phenyltheophylline (3 x 10(-6) M), or superoxide dismutase (150 U/ml) plus catalase (1,200 U/ml). ADM produced concentration-dependent relaxations only in veins with endothelium. Relaxations to ADM in rings with endothelium were significantly inhibited only by methylene blue and HS-142-1. In separate experiments, incubation of rings with ADM (10(-8) M) and 3-isobutyl-1-methyl-xanthine (10(-4) M) for 3 min did not significantly affect the accumulation of cyclic guanosine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP). These data suggest that ADM-mediated relaxation in veins is endothelium dependent and is not associated with activation of CGRP receptors or currently defined ADM receptors. Further, relaxations are not mediated by nitric oxide, indomethacin-sensitive prostanoids, TEA-sensitive hyperpolarizing factors, oxygen free radicals, or accumulation of cyclic nucleotides.

Adrenomedullin