17β-Estradiol protects against lung injuries after brain death in male rats

J Heart Lung Transplant. 2018 Nov;37(11):1381-1387. doi: 10.1016/j.healun.2018.06.015. Epub 2018 Jul 5.

Abstract

Background: Brain death elicits microvascular dysfunction and inflammation, and thereby compromises lung viability for transplantation. As 17β-estradiol was shown to be anti-inflammatory and vascular protective, we investigated its effects on lung injury after brain death in male rats.

Methods: Wistar rats were assigned to: sham-operation by trepanation only (SH, n = 7); brain death (BD, n = 7); administration of 17β-estradiol (280 μg/kg, iv) at 60 minutes after brain death (BD-E2, n = 7). Experiments were performed 180 minutes thereafter. Histopathological changes in the lung were evaluated by histomorphometry. Gene expression of inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS), and endothelin-1 was measured by real-time polymerase chain reaction. Protein expression of NO synthases, endothelin-1, platelet endothelial cell adhesion molecule-1 (PECAM-1), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), BCL-2, and caspase 3 was assessed by immunohistochemistry. Cytokines were quantified by enzyme-linked immunosorbent assay.

Results: Treatment with 17β-estradiol after brain death decreased lung edema and hemorrhage (p < 0.0001), and serum levels of cytokine-induced neutrophil chemoattractant-1 (CINC-1; p = 0.0020). iNOS (p < 0.0001) and VCAM-1 (p < 0.0001) also diminished at protein levels, while eNOS accumulated (p = 0.0002). However, gene expression of iNOS, eNOS, and endothelin-1 was comparable among groups, as was protein expression of endothelin-1, ICAM-1, BCL-2, and caspase 3.

Conclusions: 17β-Estradiol effectively reduces lung injury in brain-dead rats mainly due to its ability to regulate NO synthases. Thus, the drug may improve lung viability for transplantation.

Keywords: brain death; estradiol; inflammation; lung; male Wistar rats; microcirculation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology*
  • Brain Death / pathology*
  • Chemokine CXCL1 / blood
  • Estradiol / pharmacology*
  • Hemorrhage / pathology
  • Hemorrhage / prevention & control
  • Lung Diseases / pathology
  • Lung Diseases / prevention & control
  • Lung Injury / pathology
  • Lung Injury / prevention & control*
  • Lung Transplantation*
  • Male
  • Nitric Oxide Synthase Type II / blood
  • Nitric Oxide Synthase Type III / blood
  • Pulmonary Edema / pathology
  • Pulmonary Edema / prevention & control
  • Rats
  • Rats, Wistar
  • Vascular Cell Adhesion Molecule-1 / blood

Substances

  • Anti-Inflammatory Agents
  • Chemokine CXCL1
  • Cxcl1 protein, rat
  • Vascular Cell Adhesion Molecule-1
  • Estradiol
  • Nitric Oxide Synthase Type II
  • Nitric Oxide Synthase Type III
  • Nos2 protein, rat
  • Nos3 protein, rat