title: rhVEGF treatment preserves pulmonary vascular reactivity and structure in an experimental model of pulmonary hypertension in fetal sheep.
abstract: We have previously shown that lung VEGF expression is decreased in a fetal lamb model of PPHN and that VEGF165 inhibition causes severe pulmonary hypertension in fetal lambs. Therefore, we hypothesized that treatment with rhVEGF165 would preserve endothelium-dependent vasodilation and reduce the severity of pulmonary vascular remodeling in an experimental model of PPHN. We studied the effects of daily intrapulmonary infusions of rhVEGF after partial ligation of the ductus arteriosus (DA). We performed surgery in 24 late-gestation fetal lambs and placed catheters in the main pulmonary artery, left atrium, and aorta for pressure measurements and in the left pulmonary artery for drug infusions. A pressure transducer was placed around the LPA to measure blood flow to the left lung (Qp), and the DA was surgically constricted to induce pulmonary hypertension. rhVEGF165 or vehicle was infused for 7 or 14 days. ACh or 8-BrcGMP was infused on days 2 and 13 to assess endothelium-dependent and -independent vasodilation, respectively. ACh-induced vasodilation was reduced in PPHN lambs after 14 days (change in Qp from baseline, 106% vs. 11%). In contrast, the response to ACh was preserved in lambs treated with rhVEGF (change in Qp, 94% vs. 90%). Pulmonary vasodilation to 8-BrcGMP was not altered in PPHN lambs or enhanced by VEGF treatment. rhVEGF treatment increased expression of lung eNOS protein and decreased pulmonary artery wall thickness by 34% vs. PPHN lambs. We conclude that VEGF165 preserves endothelium-dependent vasodilation, upregulates eNOS expression, and reduces the severity of pulmonary vascular remodeling in experimental PPHN.
authors.affiliation: Pediatric Heart Lung Center and Department of Pediatrics, University of Colorado School of Medicine, Denver, CO 80045, USA. grover.theresa@tchden.org
authors.forename: Theresa R
authors.initials: TR
authors.lastname: Grover
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Parker
authors.forename: Neil E
authors.initials: NE
authors.lastname: Markham
authors.forename: Steven H
authors.initials: SH
authors.lastname: Abman
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D005333:Fetus / Q000166:cytology / Q000378:metabolism; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000378:metabolism; D008168:Lung / Q000166:cytology / Q000196:embryology / Q000378:metabolism*; D019001:Nitric Oxide Synthase / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III; D011247:Pregnancy; D011651:Pulmonary Artery / Q000166:cytology / Q000378:metabolism; D011652:Pulmonary Circulation / Q000502:physiology*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011994:Recombinant Proteins / Q000627:therapeutic use; D012756:Sheep; D042461:Vascular Endothelial Growth Factor A / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D011994:Recombinant Proteins; D042461:Vascular Endothelial Growth Factor A; D019001:Nitric Oxide Synthase; D052250:Nitric Oxide Synthase Type III