Blood oxygen transport in rats under hypothermia combined with modification of the L-Arginine-NO pathway

Methemoglobinemia Unmasked by Use of Sodium Nitroprusside and Hypothermia in a Case of Chronic Thromboembolic Pulmonary Hypertension During Pulmonary Endarterectomy: A Case Report

In performing pulmonary endarterectomy (PEA) for a patient with chronic thromboembolic pulmonary hypertension (CTEPH), we encountered methemoglobinemia that was unmasked by hypothermia while on cardiopulmonary bypass (CPB). The patient on dapsone therapy for antiphospholipid antibody syndrome had developed acquired methemoglobinemia that went undiagnosed because her cyanosis was believed to be due to CTEPH and the resulting ventilation-perfusion (V/Q) mismatch. Although pharmacological triggers for methemoglobin are well known, causation by hypothermia is not described. Monitoring saturation while on CPB was challenging because of nonpulsatile blood flow but was overcome using cerebral oximetry.

Nitric oxide regulation of microvascular oxygen

The role of nitric oxide (NO) as a highly diffusible free radical gaseous vasodilator is intrinsically linked to the control of blood flow and oxygen (O(2)) delivery to tissue. NO also is involved in regulating mitochondrial O(2) metabolism, growth of new blood vessels, and blood oxygenation through control of respiratory ventilation. Hemoglobin and myoglobin may help to conserve NO for subsequent release of a NO-related vasoactive species under hypoxic conditions. NO has a major role in regulating microvascular O(2), and dysfunctional NO signaling is associated with the pathogenesis of metabolic and cardiovascular diseases.

Effect of nitroglycerine on some parameters of the prooxidant-antioxidant balance and functional state of the liver during ischemia/reperfusion

The effect of nitroglycerine on some parameters of the prooxidant-antioxidant balance and functional state of the liver under conditions of ischemia/reperfusion was studied on rabbits. Hepatic ischemia/reperfusion was accompanied by accumulation of LPO products, depletion of the antioxidant defense system, and increase in blood transaminase activity. Nitroglycerine infusion before the reperfusion period decreased the concentration of LPO products, increased activity of the antioxidant system, and improved liver function.

The degree of oxidative stress in the rat brain during ischemia and reperfusion in conditions of correction of the L-arginine-NO system

The aim of the present work was to evaluate oxidative stress in the brains of rats during ischemia/reperfusion in conditions of correction of the L-arginine-NO system. Experiments on 128 rats with brain ischemia/perfusion in conditions of modulation of the L-arginine-NO system were used to study changes in the concentrations of (a) lipid peroxidation products, i.e., diene conjugates, malonic dialdehyde, and Schiff bases, and (b) antioxidant protection factors, i.e., retinol, alpha-tocopherol, and SH-groups. Administration of L-arginine and NO synthase inhibitors, i.e., the non-selective inhibitor N(omega)-nitro-L-arginine methyl ester, the selective neuronal NO synthase inhibitor 7-nitroindasole, and the selective inhibitor of inducible NO synthase S-methylisothiourea, established that oxidative stress in rats with brain ischemia/perfusion is NO-dependent. NO formed by the various isoforms of NO synthase had different roles: hyperactivation of neuronal NO synthase was responsible for oxidative stress in both periods of brain ischemia/reperfusion, while increased inducible NO synthase activity was responsible in the late period.

Prooxidant-antioxidant state of the organism during oxidative stress and correction of the L-arginine-NO system

The prooxidant-antioxidant balance in rats with oxidative stress was studied during correction of the L-arginine-NO system. Oxidative stress was induced by intravenous injection of E. coli lipopolysaccharide. Under conditions of oxidative stress the prooxidant-antioxidant imbalance was least pronounced during selective correction of the L-arginine-NO system. L-Arginine and nonselective NO synthase inhibitor had little protective effect.

Hypoxia, red blood cells, and nitrite regulate NO-dependent hypoxic vasodilation

Local vasodilation in response to hypoxia is a fundamental physiologic response ensuring oxygen delivery to tissues under metabolic stress. Recent studies identify a role for the red blood cell (RBC), with hemoglobin the hypoxic sensor. Herein, we investigate the mechanisms regulating this process and explore the relative roles of adenosine triphosphate, S-nitrosohemoglobin, and nitrite as effectors. We provide evidence that hypoxic RBCs mediate vasodilation by reducing nitrite to nitric oxide (NO) and ATP release. NO dependence for nitrite-mediated vasodilation was evidenced by NO gas formation, stimulation of cGMP production, and inhibition of mitochondrial respiration in a process sensitive to the NO scavenger C-PTIO. The nitrite reductase activity of hemoglobin is modulated by heme deoxygenation and heme redox potential, with maximal activity observed at 50% hemoglobin oxygenation (P(50)). Concomitantly, vasodilation is initiated at the P(50), suggesting that oxygen sensing by hemoglobin is mechanistically linked to nitrite reduction and stimulation of vasodilation. Mutation of the conserved beta93cys residue decreases the heme redox potential (ie, decreases E(1/2)), an effect that increases nitrite reductase activity and vasodilation at any given hemoglobin saturation. These data support a function for RBC hemoglobin as an allosterically and redox-regulated nitrite reductase whose "enzyme activity" couples hypoxia to increased NO-dependent blood flow.

Blood oxygen transport and endothelial dysfunction in patients with arterial hypertension

Disturbed nitric oxide (NO) synthesis leads to development of endothelial dysfunction that plays a significant role in the pathogenesis of arterial hypertension. The presence of various compounds of haemoglobin with NO can affect haemoglobin-oxygen affinity of the whole blood. Methaemoglobin and S-nitrosohaemoglobin increase it, whereas nitrosyl-haemoglobin decreases. The aim of this study was to investigate the blood oxygen transport indices and to assess the endothelial function in patients with arterial hypertension. The patients with mild hypertension had a 4.47% increased actual p50 (the blood pO(2) corresponding to its 50% oxygen saturation) (P<0.05), a diminished pO(2) (P<0.05), and a raised pCO(2) (P<0.01) as compared with the controls. The patients with severe hypertension had decreased pO(2) and pH, and actual p50 was reduced by 3.03% (P<0.05), which reflects a more pronounced oxyhaemoglobin dissociation curve shift leftwards. These changes can be assessed as a blood oxygen transport decompensation that enhanced tissue hypoxia. The results of our studies indicate that the endothelial dysfunction in patients with arterial hypertension leads to significant impairments in blood oxygen transport indices. The endothelium may be involved in development of the above blood oxygen transport impairments, since only sufficient amounts of NO maintain a normal blood flow and oxygen transport to tissues. The endothelial dysfunction leads to a disturbed production of different haemoglobin NO derivatives, which not only affects NO release at different sites of the arterial bed, but also haemoglobin-oxygen affinity and optimal blood oxygenation and deoxygenation in capillaries. These data support the notion that endothelial dysfunction may alter haemoglobin-oxygen affinity and tissue oxygen supply in vivo. Alternation of haemoglobin-oxygen supply may be involved in the pathogenesis of hypertension.