title: In vivo adenovirus-mediated endothelial nitric oxide synthase gene transfer ameliorates lung allograft ischemia-reperfusion injury.
abstract: OBJECTIVE
  Nitric oxide regulates vascular tone, inhibits platelet aggregation, and inhibits leukocyte adhesion, all of which are important modulators of ischemia-reperfusion injury. This study aimed to determine the effects of endothelial constitutive nitric oxide synthase gene transfer on ischemia-reperfusion injury in a rat lung transplant model.
  
  
  METHODS
  In group I, donor animals were injected intravenously with 5 x 10(9) pfu of adenovirus-encoding endothelial constitutive nitric oxide synthase. Groups II and III served as controls, whereby donor animals were injected with either 5 x 10(9) pfu of adenovirus encoding beta-galactosidase or saline solution, respectively. Twenty-four hours after injection, left lungs were harvested and preserved for 18 hours at 4 degrees C, then implanted into isogeneic recipients, which were put to death 24 hours later. Recombinant endothelial constitutive nitric oxide synthase gene expression was evaluated by Western blotting and immunohistochemistry. Lung grafts were assessed by measuring arterial oxygenation, myeloperoxidase activity, and wet/dry weight ratios.
  
  
  RESULTS
  Western blotting confirmed the overexpression of endothelial constitutive nitric oxide synthase in lungs so transfected compared with controls. Twenty-four hours after reperfusion, mean arterial oxygenation was significantly improved in group I compared with group II and III controls (189.4 +/- 47.1 mm Hg vs 71.7 +/- 8.9 mm Hg and 67.8 +/- 12.2 mm Hg, P =.02, P =.01, respectively). Myeloperoxidase activity, a reflection of tissue neutrophil sequestration, was also significantly reduced in group I compared with groups II and III (0.136 +/- 0.038 DeltaOD/mg/min vs 0. 587 +/- 0.077 and 0.489 +/- 0.126 DeltaOD/mg/min, P =.001, P =.01, respectively).
  
  
  CONCLUSIONS
  Adenovirus-mediated gene transfer with endothelial constitutive nitric oxide synthase ameliorates ischemia-reperfusion injury as manifested by significantly improved oxygenation and decreased neutrophil sequestration in transplanted lung isografts. Endothelial constitutive nitric oxide synthase gene transfer may reduce acute lung dysfunction after lung transplantation.
authors.affiliation: Division of Cardiothoracic Surgery, the Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO 63110, USA.
authors.forename: T
authors.initials: T
authors.lastname: Suda
authors.forename: B N
authors.initials: BN
authors.lastname: Mora
authors.forename: F
authors.initials: F
authors.lastname: D'Ovidio
authors.forename: J A
authors.initials: JA
authors.lastname: Cooper
authors.forename: M
authors.initials: M
authors.lastname: Hiratsuka
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.forename: T
authors.initials: T
authors.lastname: Mohanakumar
authors.forename: G A
authors.initials: GA
authors.lastname: Patterson
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000818:Animals; D015153:Blotting, Western; D004195:Disease Models, Animal; D015870:Gene Expression; D018014:Gene Transfer Techniques; D005822:Genetic Vectors; D008168:Lung / Q000201:enzymology* / Q000473:pathology; D016040:Lung Transplantation / Q000473:pathology; D019001:Nitric Oxide Synthase / Q000235:genetics* / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III; D010101:Oxygen Consumption; D009195:Peroxidase / Q000378:metabolism; D051381:Rats; D011916:Rats, Inbred F344; D015427:Reperfusion Injury / Q000201:enzymology / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D014184:Transplantation, Homologous
chemical_list: D009195:Peroxidase; D019001:Nitric Oxide Synthase; D052250:Nitric Oxide Synthase Type III; C496316:Nos3 protein, rat