Endothelin-1 level in epithelial lining fluid of patients with acute respiratory distress syndrome.
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.
Nakano
Yasushi
Y
Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan.
Tasaka
Sadatomo
S
Saito
Fumitake
F
Yamada
Wakako
W
Shiraishi
Yoshiki
Y
Ogawa
Yuko
Y
Koh
Hidefumi
H
Hasegawa
Naoki
N
Fujishima
Seitaro
S
Hashimoto
Satoru
S
Ishizaka
Akitoshi
A
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*
D000418:Albumins; D019332:Endothelin-1