title: Intravascular thrombosis after hypoxia-induced pulmonary hypertension: regulation by cyclooxygenase-2.
abstract: BACKGROUND
  Pulmonary hypertension induced by chronic hypoxia is characterized by thickening of pulmonary artery walls, elevated pulmonary vascular resistance, and right-heart failure. Prostacyclin analogues reduce pulmonary pressures in this condition; raising the possibility that cycloxygenase-2 (COX-2) modulates the response of the pulmonary vasculature to hypoxia.
  
  
  RESULTS
  Sprague-Dawley rats in which pulmonary hypertension was induced by hypobaric hypoxia for 14 days were treated concurrently with the selective COX-2 inhibitor SC236 or vehicle. Mean pulmonary arterial pressure (mPAP) was elevated after hypoxia (28.1+/-3.2 versus 17.2+/-3.1 mm Hg; n=8, P<0.01), with thickening of small pulmonary arteries and increased COX-2 expression and prostacyclin formation. Selective inhibition of COX-2 aggravated the increase in mPAP (42.8+/-5.9 mm Hg; n=8, P<0.05), an effect that was attenuated by the thromboxane (TX) A2/prostaglandin endoperoxide receptor antagonist ifetroban. Urinary TXB2 increased during hypoxia (5.9+/-0.9 versus 1.2+/-0.2 ng/mg creatinine; n=6, P<0.01) and was further increased by COX-2 inhibition (8.5+/-0.7 ng/mg creatinine; n=6, P< 0.05). In contrast, urinary excretion of the prostacyclin metabolite 6-ketoprostaglandin F1alpha decreased with COX-2 inhibition (8.6+/-3.0 versus 27.0+/-4.8 ng/mg creatinine; n=6, P< 0.05). Platelet activation was enhanced after chronic hypoxia. COX-2 inhibition further reduced the PFA-100 closure time and enhanced platelet deposition in the smaller pulmonary arteries, effects that were attenuated by ifetroban. Mice with targeted disruption of the COX-2 gene exposed to chronic hypoxia had exacerbated right ventricular end-systolic pressure, whereas targeted disruption of COX-1 had no effect.
  
  
  CONCLUSIONS
  COX-2 expression is increased and regulates platelet activity and intravascular thrombosis in hypoxia-induced pulmonary hypertension.
authors.affiliation: Department of Clinical Pharmacology, Royal College of Surgeons Ireland, 123 St. Stephens Green, Dublin 2, Ireland. gpidgeon@rcsi.ie
authors.forename: Graham P
authors.initials: GP
authors.lastname: Pidgeon
authors.forename: Rasa
authors.initials: R
authors.lastname: Tamosiuniene
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Irene
authors.initials: I
authors.lastname: Leonard
authors.forename: Orina
authors.initials: O
authors.lastname: Belton
authors.forename: Aidan
authors.initials: A
authors.lastname: Bradford
authors.forename: Desmond J
authors.initials: DJ
authors.lastname: Fitzgerald
mesh_terms: D000818:Animals; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology; D006976:Hypertension, Pulmonary / Q000201:enzymology* / Q000209:etiology* / Q000503:physiopathology; D000860:Hypoxia / Q000150:complications*; D008297:Male; D008565:Membrane Proteins; D015539:Platelet Activation; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism / Q000502:physiology*; D011453:Prostaglandins / Q000652:urine; D011720:Pyrazoles / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D013449:Sulfonamides / Q000494:pharmacology; D013927:Thrombosis / Q000209:etiology; D013930:Thromboxane-A Synthase / Q000378:metabolism; D000096926:Benzenesulfonamides
chemical_list: D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases; D011453:Prostaglandins; D011720:Pyrazoles; D013449:Sulfonamides; D013930:Thromboxane-A Synthase; C119130:4-(5-(4-chlorophenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl)benzenesulfonamide; D000096926:Benzenesulfonamides; C496513:Ptgs1 protein, rat