title: N-acetyl cysteine attenuates the inflammatory response in warm ischemic pig lungs.
abstract: BACKGROUND
  Lungs donated after cardiac death (DCD) may significantly reduce current organ shortage. However, the warm ischemic period following circulatory arrest may enhance ischemia-reperfusion injury (IRI). We investigated the possible therapeutic effect of N-acetyl cysteine (NAC), a potent anti-oxidative agent on IRI in a porcine ex vivo lung reperfusion model.
  
  
  METHODS
  NAC (50 mg/kg) was nebulized to pigs (n = 6/group) prior to sacrifice (NAC-DCD). In DCD-NAC, animals received NAC 15 min after death. Control animals did not receive an aerosol (DCD). Interleukin (IL)-1beta, tumor necrosis factor-alpha, IL-8, lactate dehydrogenase activity and thiobarbituric acid reactive substances were measured and cells were counted in broncho-alveolar lavage from the right lung after a 3-h warm plus 1-h cold ischemic interval.
  
  
  RESULTS
  There were no differences in cells between groups, however cell death was lower in NAC-DCD (10.3 +/- 1.5%) and DCD-NAC (7.83 +/- 1.8%) compared to DCD (18.0 +/- 3.8%). IL-1beta levels (111.5 +/- 28.8 pg/mL and 92.2 +/- 51.0 pg/mL versus 250.3 +/- 56.6 pg/mL) and lactate dehydrogenase activity (1258.0 +/- 440.9 U/L and 1606.0 +/- 289.0 U/L versus 2848.0 +/- 760.9 U/L) were significantly lower in NAC-DCD and DCD-NAC compared with DCD, respectively. These postischemic inflammatory markers correlated with functional parameters upon reperfusion of the left lung, reported in a previous study.
  
  
  CONCLUSIONS
  Administration of NAC prior to or shortly after circulatory arrest results in a marked reduction of inflammation during the warm ischemic phase.
authors.affiliation: Laboratory for Experimental Thoracic Surgery, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Geudens
authors.forename: Wim A
authors.initials: WA
authors.lastname: Wuyts
authors.forename: Filip R
authors.initials: FR
authors.lastname: Rega
authors.forename: Bart M
authors.initials: BM
authors.lastname: Vanaudenaerde
authors.forename: Arne P
authors.initials: AP
authors.lastname: Neyrinck
authors.forename: Geert M
authors.initials: GM
authors.lastname: Verleden
authors.forename: Toni E
authors.initials: TE
authors.lastname: Lerut
authors.forename: Dirk E M
authors.initials: DE
authors.lastname: Van Raemdonck
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology*; D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D004195:Disease Models, Animal; D007249:Inflammation / Q000188:drug therapy; D007511:Ischemia; D008168:Lung / Q000098:blood supply / Q000187:drug effects*; D016040:Lung Transplantation; D009926:Organ Preservation / Q000379:methods*; D015427:Reperfusion Injury / Q000188:drug therapy*; D013552:Swine; D013696:Temperature
chemical_list: D000975:Antioxidants; D000111:Acetylcysteine