title: Role of oxidant stress in the adult respiratory distress syndrome: evaluation of a novel antioxidant strategy in a porcine model of endotoxin-induced acute lung injury.
abstract: Reactive oxygen metabolites (ROMs) are thought to play a key role in the pathogenesis of the adult respiratory distress syndrome (ARDS). Accordingly, the use of ROM scavengers, such as N-acetyl-cysteine or dimethylthiourea, as therapeutic adjuncts to prevent oxidant-mediated damage to the lung have been evaluated extensively in animal models of ARDS. Results with this approach have been quite variable among studies. Another strategy that has been examined in animal models of ARDS is the administration of various enzymes, particularly superoxide dismutase (SOD) or catalase (CAT), in an effort to promote the conversion of ROMs to inactive metabolites. In theory, this strategy should be more effective than the use of ROM scavengers since a single molecule of a catalytically active molecule can neutralize a large number of molecules of a reactive species, whereas most scavengers act in a stoichiometric fashion to neutralize radicals on a mole-for-mole basis. This notion is supported by studies showing that prophylactic treatment with CAT provides impressive protection against acute lung injury induced in experimental animals by the administration of lipopolysaccharide (LPS). Results with SOD have been more variable. Recently, we have utilized a porcine model of LPS-induced ARDS to investigate the therapeutic potential of EUK-8, a novel, synthetic, low molecular salen-manganese complex that exhibits both SOD-like and CAT-like activities in vitro. Using both pre- and post-treatment designs, we have documented that treatment with EUK-8 significantly attenuates many of the features of LPS-induced acute lung injury, including arterial hypoxemia, pulmonary hypertension, decreased dynamic pulmonary compliance, and pulmonary edema. These findings support the view that salen-manganese complexes warrant further evaluation as therapeutic agents for treatment or prevention of sepsis-related ARDS in humans.
authors.affiliation: Department of Surgery, Beth Israel Hospital, Boston, Massachusetts 02215, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Gonzalez
authors.forename: J
authors.initials: J
authors.lastname: Zhuang
authors.forename: S R
authors.initials: SR
authors.lastname: Doctrow
authors.forename: B
authors.initials: B
authors.lastname: Malfroy
authors.forename: P F
authors.initials: PF
authors.lastname: Benson
authors.forename: M J
authors.initials: MJ
authors.lastname: Menconi
authors.forename: M P
authors.initials: MP
authors.lastname: Fink
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use; D000328:Adult; D000818:Animals; D002374:Catalase / Q000627:therapeutic use; D004195:Disease Models, Animal; D004731:Endotoxins / Q000633:toxicity; D005029:Ethylenediamines / Q000627:therapeutic use; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D008070:Lipopolysaccharides / Q000633:toxicity; D008168:Lung / Q000473:pathology; D055370:Lung Injury; D009942:Organometallic Compounds / Q000627:therapeutic use; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D013482:Superoxide Dismutase / Q000627:therapeutic use; D013552:Swine; D013890:Thiourea / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D004731:Endotoxins; D005029:Ethylenediamines; D016166:Free Radical Scavengers; D008070:Lipopolysaccharides; D009942:Organometallic Compounds; D017382:Reactive Oxygen Species; C090577:N,N'-bis(salicylideneamino)ethane-manganese(II); C038983:1,3-dimethylthiourea; D002374:Catalase; D013482:Superoxide Dismutase; D013890:Thiourea; D000111:Acetylcysteine