Thromboxane receptor blockade (SQ 29,548) in group B streptococcal toxin challenge in young lambs.
Early-onset neonatal group B beta-hemolytic streptococcus (GBS) infection exhibits pathophysiologic characteristics of a toxic shock syndrome, in which a cascade of inflammatory mediators are involved. Thromboxane A2 (TXA2) is thought to play an important role as a mediator of the pulmonary response to GBS toxin, because high lung lymph concentrations of a TXA2 metabolite have been observed after GBS toxin injections in sheep. The aim of this study was to evaluate the effects of a selective antagonist of the TXA2-prostaglandin endoperoxide receptor (SQ 29,548). Six unanesthetized young lambs, each serving as its own control, were given SQ 29,548 or vehicle control followed by GBS toxin challenge. Hemodynamic and lung function (lung mechanics, lung volume, ventilation) responses were followed for 5 h. When compared with the control studies, treatment with SQ 29,548 significantly altered the response to GBS toxin. SQ 29,548 reduced the increase in pulmonary and systemic vascular resistance, improved cardiac output and stroke volume, improved dynamic lung compliance but not airway resistance, and improved oxygenation. The attenuating effect of SQ 29,548 was most pronounced during the first phase of toxin response (15-90 min after toxin infusion), but significant treatment effects were also seen during the second phase (120-300 min after toxin infusion). This study demonstrates that TXA2 is an important mediator of the response to GBS toxin and is responsible for hemodynamic and lung function changes. Thromboxane receptor blockade may offer a potential therapeutic approach to infants with severe early-onset GBS sepsis.
Sandberg
K
K
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Edberg
K E
KE
Fish
W
W
Parker
R A
RA
Hellerqvist
C
C
Sundell
H
H
D000403:Airway Resistance / Q000187:drug effects; D000818:Animals; D001427:Bacterial Toxins / Q000633:toxicity*; D019086:Bridged Bicyclo Compounds, Heterocyclic; D002302:Cardiac Output / Q000187:drug effects; D004195:Disease Models, Animal; D005231:Fatty Acids, Unsaturated; D006439:Hemodynamics / Q000187:drug effects; D006834:Hydrazines / Q000494:pharmacology*; D008168:Lung / Q000187:drug effects / Q000502:physiology; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D017482:Receptors, Thromboxane / Q000037:antagonists & inhibitors*; D015656:Respiratory Mechanics / Q000187:drug effects; D012756:Sheep; D013290:Streptococcal Infections / Q000188:drug therapy / Q000503:physiopathology; D013292:Streptococcus agalactiae; D013318:Stroke Volume / Q000187:drug effects; D013928:Thromboxane A2 / Q000037:antagonists & inhibitors; D014655:Vascular Resistance / Q000187:drug effects
D001427:Bacterial Toxins; D019086:Bridged Bicyclo Compounds, Heterocyclic; D005231:Fatty Acids, Unsaturated; D006834:Hydrazines; D017482:Receptors, Thromboxane; D013928:Thromboxane A2; C045749:SQ 29548