title: Modulation of pulmonary NA+ pump gene expression during cold storage and reperfusion.
abstract: BACKGROUND
  Reperfusion injury with pulmonary edema continues to be a major complication after lung transplantation. Alveolar fluid homeostasis is regulated by Na+/K+-ATPase activity on the basolateral surface of alveolar epithelial cells. Intact Na+/K+-ATPase is essential to the resolution of pulmonary edema. We characterized the effects of cold ischemia and reperfusion on expression of Na+/K+-ATPase mRNA and protein.
  
  
  METHODS
  Baseline values for Na+/K+-ATPase mRNA and protein were determined from freshly harvested lungs with no cold storage time or reperfusion (group I). Group II lungs were analyzed after cold storage times of 12 or 24 hr without subsequent reperfusion. Group III lungs were analyzed after cold storage times of 12 or 24 hr with subsequent reperfusion. Lungs were flushed with either Euro-Collins (EC) or University of Wisconsin (UW) solution in each group. All samples were quantified for Na+/K+-ATPase mRNA and Na+/K+-ATPase protein. Physiological parameters including oxygenation and compliance were also measured.
  
  
  RESULTS
  There were no significant differences in the level of mRNA and protein for samples that were cold stored without reperfusion (group II). With reperfusion (group III) there was a significant increase in the level of the Na+/K+-ATPase mRNA after 12 hr of storage for both EC and UW. After 24 hr of storage and subsequent reperfusion, lungs flushed with EC had significantly decreased Na+/K+-ATPase protein and mRNA, although lungs preserved with UW maintained their increased levels of Na+/K+-ATPase protein and mRNA.
  
  
  CONCLUSIONS
  Our data suggest that ischemia-reperfusion injury results in an initial up-regulation of Na+/K+-ATPase mRNA. With prolonged injury in lungs preserved with EC, the level of the mRNA decreased with a corresponding decrease in the Na+/K+-ATPase protein. The different response seen in EC versus UW may be explained by better preservation of pump function with UW than EC and correlates with improved physiological function in lungs preserved with UW solution.
authors.affiliation: Department of Cardiothoracic Surgery, University of Southern California and Childrens Hospital Los Angeles, 90033, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Kim
authors.forename: C J
authors.initials: CJ
authors.lastname: Baker
authors.forename: S I
authors.initials: SI
authors.lastname: Danto
authors.forename: V A
authors.initials: VA
authors.lastname: Starnes
authors.forename: M L
authors.initials: ML
authors.lastname: Barr
mesh_terms: D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D015153:Blotting, Western; D015925:Cryopreservation; D015870:Gene Expression; D005978:Glutathione / Q000494:pharmacology; D007328:Insulin / Q000494:pharmacology; D008168:Lung / Q000098:blood supply / Q000201:enzymology*; D008170:Lung Compliance; D008297:Male; D019188:Organ Preservation Solutions / Q000494:pharmacology; D012333:RNA, Messenger / Q000378:metabolism; D011887:Raffinose / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000235:genetics*; D012260:Ribonucleases / Q000032:analysis; D000254:Sodium-Potassium-Exchanging ATPase / Q000235:genetics*; D014021:Tissue Preservation
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; D012333:RNA, Messenger; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D012260:Ribonucleases; D000254:Sodium-Potassium-Exchanging ATPase; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose