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Effect of verapamil on monocrotaline-induced pulmonary artery hypertension and endothelial cell dysfunction in rats.

Verapamil, a calcium channel blocker has been used with partial success in cases of primary pulmonary hypertension, as well as to reduce hypoxia-induced pulmonary hypertension (PH) in rats. However, its effect on monocrotaline (MCT)-induced PH in rats is not known. We studied the effect of verapamil on MCT-induced PH. Three weeks after a single injection of MCT, significant PH was noted in the MCT-injected rats compared with control (44.35 +/- 3.5 vs. 22 +/- 2.5 mmHg). MCT-injected rats on daily verapamil showed significant reduction in PH (31.5 +/- 3.4 mmHg). The main pulmonary artery of MCT-injected rats revealed subendothelial thickening, thinning and fragmentation of elastic laminae, smooth muscle cell hypertrophy and necrosis or loss of smooth muscle cells, and increased amounts of collagen in media and adventitia. In contrast, the main pulmonary artery of MCT + VP-treated rats showed less intimal thickening, some smooth muscle cell hypertrophy, but little necrosis or loss of cells in addition to disappearance of outer elastic laminae. Smaller pulmonary arteries (less than 150 microns in diameter) in MCT + VP-treated rats showed less medial thickening than MCT groups. However, diminished lung angiotensin-converting enzyme activity suggestive of endothelial cell dysfunction was noted in both MCT and MCT + VP-treated rats. This study indicates that verapamil attenuates MCT-induced PH, but has no effect on pulmonary endothelial cell dysfunction.

Animals

Responses of coronary arteries of cardiac transplant patients to acetylcholine.

Accelerated coronary atherosclerosis is a major cause of graft failure after heart transplantation. Graft atherosclerosis is typically diffuse and difficult to detect even with coronary arteriography. Recently, acetylcholine was shown to dilate blood vessels by releasing a vasorelaxant substance from the endothelium (endothelium-derived relaxing factor). We have demonstrated paradoxical vasoconstriction induced by acetylcholine both early and late in the course of coronary atherosclerosis in patients, suggesting an association of endothelial dysfunction and atherosclerosis. In this report, we tested the hypothesis that coronary arteries of heart transplant patients can show endothelial dysfunction before or in the early stages of angiographically evident coronary atherosclerosis. Acetylcholine was infused into the left anterior descending artery of 13 heart transplant patients at 12 (n = 9) and 24 (n = 4) mo after transplantation. Vascular responses were evaluated by quantitative angiography. Among patients with angiographically smooth coronary arteries, relatively few (6/25) arterial segments had preserved vasodilator responses, while the majority failed to dilate (10/25) or paradoxically constricted (9/25). Angiographically irregular coronary arteries were present in three patients, in whom 8/10 segments showed marked paradoxical constriction and the remaining 2/10 failed to dilate. Only 1 of 13 patients retained appropriate dilation to acetylcholine in all segments. Nitroglycerin, which acts directly on vascular smooth muscle, dilated nearly all segments. No clinical features of the patients, including myocardial rejection appeared to correlate with the impaired functional response of vessels. Thus impaired response to acetylcholine is a common early finding in heart transplant patients and emphasizes the potential importance of endothelial dysfunction in the development of atherosclerosis.

Acetylcholine

Free radicals mediate endothelial cell dysfunction caused by elevated glucose.

Impaired endothelium-dependent relaxation occurs in diabetic rabbit aorta and normal aorta exposed to elevated concentrations of glucose and is prevented by cyclooxygenase inhibitors. The role of free radicals in the endothelial cell impairment was examined with free radical scavengers and in aortas from rabbits fed with probucol (1% wt/wt, a lipid-soluble antioxidant). Rings of aorta suspended for measurement of isometric tension were incubated for 6 h in control (5.5 mM) or elevated (44 mM) glucose. Impairment of endothelium-dependent relaxation to acetylcholine caused by exposure to elevated glucose was prevented by superoxide dismutase, catalase, deferoxamine, or allopurinol and did not occur in aortas from probucol-fed rabbits. Similarly, impairment of acetylcholine relaxations in aortas from alloxan-induced diabetic rabbits was restored to normal by superoxide dismutase. Oxygen-derived free radicals generated by xanthine oxidase also caused impaired acetylcholine relaxations. Exposure of aortic segments to elevated glucose or to xanthine oxidase caused a significant increase in release of immunoreactive prostanoids. These data indicate that the endothelial cell dysfunction caused by elevated glucose is mediated by free radicals that are likely generated through the increased cyclooxygenase catalysis occurring in the endothelium. Treatment with antioxidants protects against impaired endothelium-dependent relaxations caused by elevated glucose.

Animals

Endothelial cell dysfunction in HIV infection.

We have investigated plasma levels of endothelial cell products playing a role in hemostasis in 125 HIV-positive patients and 30 controls. Antigenic von Willebrand factor increased significantly with disease progression and was closely correlated with CD4+ cell counts and beta 2-microglobulin levels. Tissue-type plasminogen activator was normal in CDC II/III and CDC IVC2 patients and was slightly increased in AIDS patients, whereas plasminogen activator inhibitor was increased in each group, the stage of the disease not having any effect. Mean total protein S levels were lower in HIV-positive patients and, in 27.2% of the cases, were associated with a decrease in free protein S levels. Such abnormalities could be responsible for a hypercoagulable state in these patients and could be explained by endothelial cell damage during HIV infection. Whether this injury is due to HIV itself remains to be further investigated.

Adult

Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia.

The pregnancy disorder preeclampsia continues as a major cause of maternal and infant mortality and morbidity. Despite intensive research since its recognition 100 years ago, our lack of understanding is evidenced by therapy which remains empiric, early delivery. Part of our failure to more completely understand the syndrome is due to excessive attention to the blood pressure elevation which accompanies the disorder, to the exclusion of a panoply of other physiologic aberrations. Although hypertension, if markedly elevated, can lead to maternal morbidity, it is not usually an important contributor to the pathophysiology of preeclampsia. It is primarily important as a marker for vasoconstriction, which in association with activation of coagulation reduces perfusion to many organs, including the fetal-placental unit. The earliest and likely most important pathophysiologic change is reduced placental perfusion secondary to abnormal implantation and/or a relative increase in placental mass. We propose that reduced placental perfusion results in the production of agent(s) by this organ, which injures or activates endothelial cells. The resulting endothelial cell dysfunction increases sensitivity to normal endogenous pressors, activates the coagulation cascade, and increases vascular permeability. These changes produce the characteristic pathophysiologic changes of the disorder. Evidence supporting this hypothesis includes abnormal endothelial morphology long recognized in glomerular capillaries, increased circulating fibronectin, and increased plasma mitogenic activity that long antedates the clinical disorder. In addition, an agent(s) is present in the blood of these women which activates endothelial cells in vitro as evidenced by increased release of [51Cr] chromium and increased production of PDGF. Preeclampsia is clearly more than "pregnancy induced hypertension."

Endothelium, Vascular

Indications of vascular endothelial cell dysfunction in systemic lupus erythematosus.

Fibrinolytic and other factors have been measured in 73 patients with systemic lupus erythematosus or related conditions to determine whether clinical thrombosis, a common feature of these disorders, is associated with defective fibrinolysis. Twenty five of 72 (35%) patients, compared with two of 22 (9%) controls, showed a low level of plasminogen activator activity in response to venous occlusion, suggesting decreased fibrinolytic potential. In addition, mean plasma levels of von Willebrand factor antigen and fibronectin were markedly raised in the patients (mean (SD) 384.5 (277)% and 727 (436) mg/l respectively) compared with healthy controls (100 (50)% and 306 (65) mg/l). These data suggest a degree of endothelial cell dysfunction. No clear correlation was found between a history of thrombosis and any plasma factor measured, except for prolongation of clotting tests suggestive of the 'lupus anticoagulant'.

Adult

Antibody to CD-18 exerts endothelial and cardiac protective effects in myocardial ischemia and reperfusion.

We studied the effects of MAbR15.7, an antibody directed against the common beta-chain (CD-18) of a family of neutrophil adherence glycoproteins, on endothelial dysfunction and myocardial injury in a model of myocardial ischemia and reperfusion in cats. Pentobarbital-anesthetized cats were subjected to 1.5 h occlusion of the left anterior descending coronary artery (LAD) and 4.5 h of reperfusion. MI + R resulted in severe myocardial injury and endothelial dysfunction, including significant elevation of plasma creatine kinase (CK) activity, marked myocardial necrosis, high cardiac myeloperoxidase (MPO) activity in ischemic cardiac tissue, and loss of response of LAD coronary rings to the endothelium-dependent vasodilators, acetylcholine (ACh) and A-23187. In contrast, MAbR15.7-treated cats exhibited a lower plasma CK activity at every time point observed after 2 h, a reduced area of cardiac necrosis (2 +/- 1 vs. 30.8 +/- 2.5% of area-at-risk, P less than 0.001), lower MPO activity in the ischemic region (P less than 0.01), and significantly preserved vasorelaxant responses of LAD coronary rings to endothelium-dependent vasodilators, ACh (P less than 0.001), and A-23187 (P less than 0.001). These results indicate that myocardial ischemia and reperfusion induces significant myocardial injury and endothelial dysfunction in the cat involving a CD18-dependent neutrophil adherence mechanism. Inhibition of neutrophil adherence to the endothelium exerts significant protective effects in this model of reperfusion injury.

Acetylcholine

Nebivolol treatment improves hypertension-induced endothelial cell dysfunction by reducing TGF-β1-dependent senescence and normalizing mitochondrial indices.

OBJECTIVES: Serum from patients with hypertension (HT) causes endothelial cell (EC) damage, leading to senescence and dysfunctional phenotype. This study investigated whether serum from patients treated with the antihypertensive drugs could normalize EC activity. METHODS: This study involved 71 patients with newly diagnosed HT, who were randomly assigned to one of three groups based on the antihypertensive treatment: amlodipine, nebivolol, or perindopril. Serum samples collected before and 6 weeks after treatment were applied to ECs in vitro to assess their angiogenic activity, cellular senescence, mitochondrial metabolism, and oxidative stress. RESULTS: Results showed that exposure of ECs to serum from patients treated for 6 weeks significantly altered EC function, with varying effects among the drugs. Serum from nebivolol-treated patients produced the most consistent benefits, reducing EC proliferation and HIF-1α expression, likely due to lower levels of angiogenic factors such as angiopoietin-1, basic fibroblast growth factor (bFGF), insulin-like growth factor 1 (IGF-1), and vascular endothelial growth factor (VEGF). Additionally, this serum contained reduced levels of pro-inflammatory cytokines (E-selectin, P-selectin, monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor α (TNFα)) and lower TGF-β1, which are linked to HT-related EC senescence. Nebivolol treatment decreased senescence biomarkers such as SA-β-Gal, 53BP1, and p16, with SA-β-Gal reduction comparable to that of TGF-β1 neutralizing antibodies. Oxidative stress was reduced, indicated by lower oxidized DNA product levels. CONCLUSIONS: Nebivolol was the most effective at reducing the factors, associated with HT induced cellular senescence of endothelium, through reducing TGF-β1.

Humans

Early pulmonary endothelial enzyme dysfunction after phorbol ester in conscious rabbits.

We investigated changes in angiotensin converting-enzyme (ACE) activity before and at 5, 15, 60, and 240 min after 20 micrograms phorbol myristate acetate/kg body wt iv in conscious rabbits. ACE activity was estimated in vivo from the single-pass transpulmonary metabolism of the synthetic substrate [3H]benzoyl-Phe-Ala-Pro [( 3H]BPAP) under first-order reaction conditions. Within 5 min after PMA administration, all animals developed profound granulocytopenia (15% of control) and moderate thrombocytopenia (57% of control), both lasting for the duration of the experiment. Concomitantly, there was a significant decrease in the transpulmonary metabolism of [3H]BPAP and the calculated apparent first-order reaction constant Amax/Km of ACE for [3H]BPAP. No histological evidence of lung injury was observed at these times. Since a concomitant fall in the permeability surface area product for urea was also observed, we considered that the apparent decline in ACE activity might have resulted from a reduction in perfused endothelial surface area. To resolve this, we studied the effect of PMA on the Km (a measure of enzyme affinity for its substrate) and Amax (a derivative of Vmax that is dependent upon total enzyme present and thus capillary surface area) of ACE and 5'-nucleotidase for [3H]BPAP and [14C]AMP, respectively. A significant increase in Km for both enzymes was observed at 1 h after PMA, whereas Amax was unaffected, suggesting that low-dose PMA may indeed produce endothelial cell enzyme dysfunction independent of its effect on capillary surface area. These results provide evidence of pulmonary capillary functional injury before or in the absence of structural endothelial damage.

Adenosine Monophosphate

[Disorders of thrombocyte function and/or endothelial cell damage as a cause of primary pulmonary hypertension?].

The pathophysiology of pulmonary hypertension is, in many cases, unclear and this is true especially for patients with dietary pulmonary hypertension. This paper discusses the hypothesis that platelets, directly or through their interaction with the pulmonary endothelial cell, are involved in the development of pulmonary hypertension. Platelets release vasoactive substances during aggregation or activation and these substances lead to pulmonary vasoconstriction and pulmonary hypertension. The primary target of the activated platelets could be the endothelial cell which has also been demonstrated in animal experiments with crotalaria-induced pulmonary hypertension. Changes in thromboxane--platelets and prostacyclin--endothelial cell interactions could be the basic mechanism responsible for endothelial proliferation and pulmonary vasoconstriction. It has not been ascertained, however, whether the activation of platelets or endothelial dysfunction is the primary lesion. In various animal experiments, changes in platelet function and endothelial damage, as well, have been shown to be initiated by exogenous influences. The investigation of platelets or endothelial cell function in patients with pulmonary hypertension showed evidence of platelet activation but not platelet hyperreactivity. An impaired fibrinolytic activity, which was found in the majority of these patients, was regarded as indicative of endothelial dysfunction. An interference in the physiological interaction of circulating platelets and endothelial cells in the lung with resulting endothelial proliferation and vessel occlusion could well be the initial factor. This process would be self-perpetuating in the development of pulmonary hypertension. An additional example of dietary-induced pulmonary hypertension was observed in patients in Spain after the ingestion of toxic oil.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Calcium antagonists in experimental atherosclerosis. Use-dependence of isradipine: a potential explanation for enhanced action in atherosclerotic animals and tissue selectivity.

In the context of atherosclerosis, calcium antagonists should be evaluated from two points of view: their hemodynamic action on the atherosclerotic cardiovascular system, and their preventive action on atherosclerosis. Contraction of atherosclerotic vessels in response to vasoconstrictors, especially serotonin and acetylcholine, is enhanced mainly because of endothelial dysfunction. Due to their antivasoconstrictor effect, calcium antagonists partly compensate for this endothelial dysfunction. Agents which show a pronounced 'use-dependence', such as isradipine, are of particular interest as their action increases with the intensity of contraction. Therefore, their action is most prominent where it is most needed. Nevertheless, experiments in atherosclerotic animals indicate that the dose has to be chosen more cautiously than for young animals, as the dose-response curve for several effects is bell-shaped. Calcium antagonists also interfere with the process of atherosclerosis. In cholesterol-fed rabbits, lesion development is reduced, and regression after reverting to a normal diet is modestly enhanced. Calcium antagonists do not lower blood lipid levels. However, they attenuate proliferative lesions following endothelial damage due to a balloon catheter or electrical stimulation. The mechanism of these effects is still not clear. Blockade of the potential-sensitive L-type calcium channel is probably the important mechanism. Many types of cells (macrophages, other leukocytes and platelets, smooth muscle cells, connective tissue cells, endothelium, etc.) are involved in the genesis of atherosclerotic plaques, but it is not known which of these are the important targets of calcium antagonists. Calcium antagonists are most effective when administered at the onset of atherosclerosis, as they probably inhibit events occurring during the initiation of the atherosclerotic process.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Clinical investigations on the corneal endothelium.

The normal level of the corneal thickness and hydration is maintained by the barrier function and active fluid pump of the corneal endothelium. Three methods are currently available for the clinical study of this cell layer: (1) endothelial dysfunction results in a corneal swelling, and measurement of the corneal thickness allows the degree of endothelial damage and its repair processes to be evaluated; (2) the state of the barrier function may be studied through determination of the endothelial permeability to fluorescein; and (3) the endothelium can be photographed by specular microscopy, and the cell density and cell size distribution can be studied by morphometric analyses. A follow-up study of the cell transformation after surgical trauma revealed that the human endothelium shows very little proliferative activity, and the damaged area is covered by migration of cells in the surrounding area. It appears that the traumatized endothelium loses cells at a faster rate than that seen in the normal aging process, and endothelial dysfunction may develop many years after injury.

Adolescent

Oxysterol-induced endothelial cell dysfunction in culture.

Cholesterol oxidation products (oxysterols), such as cholestan-3 beta,5 alpha,6 beta-triol (Triol), may be atherogenic by altering the barrier function of the vascular endothelium. We have shown that incubation of endothelial cell monolayers with Triol increased transendothelial albumin transfer (i.e., decreased barrier function) in a concentration- and time-dependent manner. Such dysfunction of endothelium could result from alterations in membrane characteristics, including changes in membrane-associated enzyme activities. To test this hypothesis, endothelial monolayers were treated with 20 microM Triol and the activities of selected membrane enzymes were measured at 0, 2, 4, 6, 12 and 24 hours. Calcium-adenosine triphosphatase (Ca(++)-ATPase) and sodium, potassium, magnesium-adenosine triphosphatase (Na+, K+, Mg(++)-ATPase) activities were significantly increased after 4 or 2 hours incubation with 20 microM Triol, respectively. 5'-nucleotidase activity was significantly elevated only after a 24-hour exposure to Triol, whereas there was no change in angiotensin-converting enzyme (ACE) activity in response to 20 microM Triol treatment at any time studied. Compared with all concentrations tested 40 microM Triol increased Ca(++)-ATPase activity most markedly, with a significant increase already after a 2-hour exposure. No major morphological changes were noted until 12 hours of exposure to 20 microM Triol; obvious cellular damage was observed by 24 hours. Cultures treated with Triol for 24 hours showed significant signs of toxicity, measured by an elevated [3H]adenine release, compared with control cultures. These data demonstrate that Triol alters the activity of certain membrane-bound enzymes, particularly Na+, K+, Mg(++)-ATPase and Ca(++)-ATPase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine

Hyperoxia reduces plasma membrane fluidity: a mechanism for endothelial cell dysfunction.

To evaluate the relative contributions of three possible mechanisms that can be advanced to explain the observation that hyperoxia decreases serotonin uptake by endothelial cells, we examined the effect of high O2 tensions on Na+-K+-ATPase activity, ATP content, and plasma membrane fluidity in cultured endothelial cells. Confluent monolayers of pulmonary artery and aortic endothelial cells were exposed to 95% O2 (hyperoxia) or 20% O2 (controls) in 5% CO2 at 1 ATA for 4-42 h. Exposure to high O2 tensions had no effect on Na+-K+-ATPase activity or ATP content in pulmonary artery or aortic endothelial cells in culture. However, hyperoxia decreased the fluidity of the plasma membrane of pulmonary artery and aortic endothelial cells in culture, and the time course for the decrease in fluidity parallels that of the hyperoxic inhibition of serotonin transport. These results indicate that hyperoxia decreases fluidity in the hydrophobic core of the plasma membranes of cultured endothelial cells. Such decreases in plasma membrane fluidity may be responsible for hyperoxia-induced alterations in membrane function including decreases in transmembrane transport of amines.

Adenosine Triphosphate

Endothelial function in relation to low-level chronic residential air pollution in a general population: a cohort study.

BACKGROUND: Given the recently updated clean-air targets, this population study assessed endothelial function at low exposure to particulate matter with an aerodynamic diameter of &#x2264;10&#xa0;&#xb5;m (PM10) and &#x2264;2.5&#x2009;&#xb5;m (PM2.5), nitrogen dioxide (NO2) and black carbon (BC). METHODS: In 453 Flemish participants (47.7% women; mean age, 52.8&#x2009;years), endothelial function was assessed by finger photoplethysmography after 5&#x2009;min of ischaemia. The outcome measures were the maximal ischaemic-to-control ratio (Rmax) and the maximal difference (Dmax) in pulse amplitude between the test and control fingers. The air pollutants were related to Rmax and Dmax using mixed models accounting for coresidence, to cardiovascular endpoints by proportional hazards regression, and to residential address by high-resolution spatiotemporal interpolation. RESULTS: From 2010 to 2015, PM10, PM2.5, NO2 and BC decreased (p&#x2009;<&#x2009;0.0001) with 6-year levels averaging 15.9, 12.8, 14.3 and 1.04&#xa0;&#xb5;g/m3. Irrespective of adjustment for risk factors, Dmax was inversely correlated with PM2.5, while associations of Rmax with PM2.5 and associations of both Dmax and Rmax with other pollutants were weaker (p values <0.10), but consistently inverse. Association sizes of Rmax and Dmax with PM10 and PM2.5 weakened over 6&#xa0;years, paralleling the decreasing air pollutants (p&#x2009;&#x2264;&#x2009;0.044). In adjusted analyses, the risk of a composite cardiovascular endpoint decreased (p&#x2009;&#x2264;&#x2009;0.043) with higher Rmax and Dmax with hazard ratios ranging from 0.31 to 0.49. Finally, in the geographical analysis, endothelial dysfunction followed the spatial gradients in PM2.5. CONCLUSIONS: Long-term low-level air pollution is associated with subclinical endothelial dysfunction, the initial and critical step leading to adverse cardiovascular outcomes.

Humans

Factors determining the activity of ischemic heart disease.

Transient regional myocardial ischemia appears to underlie symptoms such as angina pectoris and represents a key pathophysiologic step, since it is an objective marker of disease activity and is capable of causing disabling symptoms and damage to left ventricular myocardium. A study of the characteristics of transient ischemia in and out of the hospital has shown that symptoms are an inconsistent underestimation of these events. Ischemia is generally prolonged, mostly asymptomatic, and usually accompanied by a regional decrease in myocardial perfusion. Studies out of the hospital have also shown that these episodes are frequently triggered by a wide range of ordinary everyday activities. These new features of transient ischemia are worth noting when searching for relevant causes that are present during everyday life and when trying to choose more rational therapy. More detailed studies of patient activity have shown that different levels of mental arousal are the most common triggering mechanism causing ischemia out of the hospital. In addition, the occurrence of transient ischemia during everyday life displays a circadian rhythm, with an increase and peak occurrence between 6:00 A.M. and 12 noon each day. The day-to-day variability of ischemia is marked, indicating functional disturbances of coronary stenoses against a background of a severe reduction in cross-sectional area. The examination of proximal stenoses has shown that the reduction in cross-sectional area is usually underestimated by conventional angiography; pressure gradients across coronary stenoses are common and, with reduced poststenotic blood pressure, can jeopardize perfusion; disturbances of vessel caliber and antegrade flow can accompany many of the ordinary everyday activities known to trigger ischemia detected in Holter tapes studied out of the hospital; and there is clear-cut evidence of endothelial dysfunction in these patients, with reversal of the normal dilator response to acetylcholine and paradoxical constriction of stenoses. This evidence of endothelial dysfunction in humans could be central to the problems of atheromatous narrowing, thrombus, and disturbed vasomotion.

Angina Pectoris

Coronary endothelial and cardiac protective effects of a monoclonal antibody to intercellular adhesion molecule-1 in myocardial ischemia and reperfusion.

BACKGROUND: Intercellular adhesion molecule-1 (ICAM-1) is a major ligand on endothelial cells for adherence of activated polymorphonuclear leukocytes (PMNs). The major purpose of this study was to study the effects of RR1/1, a monoclonal antibody against ICAM-1 (i.e., MAb RR1/1), on myocardial injury and endothelial dysfunction associated with myocardial ischemia and reperfusion. METHODS AND RESULTS: Either MAb RR1/1 (2 mg/kg, n = 7), an antibody that was found to bind selectively to endothelial cells in the cat, or MAb R3.1 (2 mg/kg, n = 7), a nonbinding control antibody, was given as an intravenous bolus 10 minutes before reperfusion. Two hundred eighty minutes later, hearts were excised. The left ventricle area-at-risk (AAR) was similar in MAb RR1/1 (29 +/- 2%) and MAb R3.1 (30 +/- 3%) groups. In MAb R3.1-treated cats, 90 minutes of myocardial ischemia plus 4.5 hours of reperfusion induced a significant myocardial injury (necrotic tissue/AAR, 28 +/- 2%), high myeloperoxidase activity (0.65 +/- 0.16 units/100 mg ischemic tissue), and a marked decrease in endothelium-dependent vasorelaxation in isolated left anterior descending coronary arteries (vasorelaxation to acetylcholine, 29 +/- 3%) with no change in endothelium-independent vasorelaxation (relaxation to NaNO2, 91 +/- 3%). However, cats treated with MAb RR1/1 developed significantly less myocardial necrosis (10 +/- 2% of the AAR, p less than 0.01), lower myeloperoxidase activity in ischemic myocardial tissue (0.2 +/- 0.03 units/100 mg ischemic tissue, p less than 0.01), and enhanced vasorelaxant responses to endothelial-dependent relaxation to acetylcholine (53 +/- 5%) compared with ischemic/reperfused cats treated with Mab R3.1. Furthermore, addition of MAb RR1/1 in vitro significantly inhibited unstimulated PMN adherence to ischemic-reperfused coronary artery endothelium. CONCLUSIONS: These results suggest that ICAM-1-dependent PMN adherence plays an important role in reperfusion injury, and that PMN adherence and infiltration contribute significantly to coronary endothelial dysfunction.

Animals

Clinical investigations on the corneal endothelium-XXXVIII Edward Jackson Memorial Lecture.

The normal thickness and transparency of the cornea is maintained by the barrier function and the active fluid pump of the corneal endothelium. The major barrier is the intercellular gap junctions, and the fluid pump depends on the active transport of bicarbonate ions. Three methods are currently available for studying this important cell layer. (1) Endothelial dysfunction produces corneal swelling, and measuring the thickness of the swelling permits the degree of damage and the repair processes to be evaluated. (2) The endothelium's permeability to fluorescein reflects the state of its barrier. (3) The morphometric measurements obtained by specular microscopy of the endothelial cells permit the cell size distribution pattern and any alterations in it to be studied. Although the cell size distribution is normal in the young adult, cellular pleomorphism increases and cell density decreases during the aging process. A follow-up study of cell transformation after surgical trauma disclosed that the human endothelium shows practically no proliferative activity and that the damaged area is covered by means of cell migration. This migration, however, is incomplete, resulting in persistent regional differences in the cell distribution pattern. The traumatized endothelium continues to lose cells at an accelerated rate and endothelial dysfunction may develop many years after injury.

Adolescent