From the Departments of Neurosurgery, Cell Biology and Physiology, and
Anatomy and Neurobiology, Washington University School of Medicine, and St
Louis Children's Hospital, St Louis, Mo.
Correspondence to Jeffrey M. Gidday, PhD, Department of Neurosurgery, Box 8057, Washington University School of Medicine, St Louis, MO 63110. E-mail gidday{at}kids.wustl.edu
Background and PurposeRecent
studies indicate that leukocytes are important contributors to
secondary vascular and parenchymal injury after cerebral
ischemia. The present study was undertaken to define nitric
oxide (NO)-based mechanisms that regulate
leukocyte-endothelial interactions in the cerebral
vasculature, how these mechanisms are affected by cerebral
ischemia, and whether NO-based therapies can affect
postischemic leukocyte dynamics.
MethodsLeukocyte adherence to pial venules of
anesthetized newborn piglets was quantified by in situ
fluorescence videomicroscopy through closed cranial windows
during basal conditions and during reperfusion after 9 minutes of
asphyxia. Nitric oxide synthase (NOS) was inhibited by local window
superfusion of L-nitroarginine; superfusion of sodium
nitroprusside was used to donate NO.
ResultsLocal inhibition of NOS under resting conditions
increased leukocyte-endothelial adherence 2.2-fold and
3.9-fold over baseline values after 1 hour and 2 hours, respectively;
this response was completely blocked by cosuperfusion with
L-arginine. Cosuperfusion of superoxide dismutase reversed
L-nitroarginine-induced leukocyte adherence by 89% and
63% at these respective time points. The extent of acute leukocyte
adherence elicited by NOS inhibition was similar in magnitude to that
observed during the initial 2 hours of reperfusion after asphyxia.
Leukocyte adherence was not additionally increased in asphyxic animals
treated with L-nitroarginine. Sodium nitroprusside robustly
inhibited asphyxia-induced leukocyte adherence back to control
levels.
ConclusionsNO exerts a tonic antiadherent effect in the cerebral
microcirculation by inactivation of adherence-promoting superoxide
radical formation. Cerebral ischemia is associated with an
inhibition of NOS or lower levels of NO, which results in
leukocyte-endothelial adherence that can be prevented
by NO donors. The latter may be useful therapeutically to prevent the
purported vascular and parenchymal dysfunction and injury caused by
activated leukocytes in ischemic brain.
Guest Editors Safar Center for Resuscitation Research
Departments of Anesthesiology and Critical Care Medicine University
of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
© 1998 American Heart Association, Inc.
Original Contributions
Modulation of Basal and Postischemic Leukocyte-Endothelial Adherence by Nitric Oxide
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