title: Endothelin-1 level in epithelial lining fluid of patients with acute respiratory distress syndrome.
abstract: OBJECTIVE
  Endothelin-1 (ET-1), a potent vasoconstrictor peptide produced by endothelial cells, has been implicated in the dysfunction of various organs. To determine the role of ET-1 in acute lung injury (ALI) and ARDS, ET-1 levels were measured in epithelial lining fluid (ELF) and plasma obtained from patients with ALI/ARDS.
  
  
  METHODS
  A cross-sectional study of patients with ALI/ARDS in the intensive care unit of two university hospitals was performed. Patients with ALI/ARDS underwent bronchoscopic microsampling to collect ELF on the day of onset of the disease. Patients who underwent bronchoscopy to examine a small peripheral pulmonary nodule served as controls.
  
  
  RESULTS
  In the 23 patients with ALI/ARDS, the ET-1 level in ELF was significantly greater than that in plasma (P < 0.001). In contrast, ET-1 was not detectable in the ELF from six of the seven control subjects. The albumin concentration of ELF, used as a marker of endothelial and epithelial permeability, correlated with the ET-1 level in ELF (P < 0.001). The oxygenation index (PaO(2)/FiO(2)) was also correlated with ET-1 concentration in ELF (P < 0.001).
  
  
  CONCLUSIONS
  In patients with ALI/ARDS, ET-1 is produced mainly in the lung and is associated not only with pulmonary vasoconstriction but also the development of permeability oedema, leading to the impairment of oxygenation.
authors.affiliation: Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakano
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Tasaka
authors.forename: Fumitake
authors.initials: F
authors.lastname: Saito
authors.forename: Wakako
authors.initials: W
authors.lastname: Yamada
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Shiraishi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Koh
authors.forename: Naoki
authors.initials: N
authors.lastname: Hasegawa
authors.forename: Seitaro
authors.initials: S
authors.lastname: Fujishima
authors.forename: Satoru
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis; D001999:Bronchoscopy; D003124:Colorimetry; D003430:Cross-Sectional Studies; D019332:Endothelin-1 / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D000418:Albumins; D019332:Endothelin-1