title: Protective effects of adenosine A2A receptor agonist in ventilator-induced lung injury in rats.
abstract: OBJECTIVE
  Mechanical ventilation is associated with overwhelming inflammatory responses that are associated with ventilator-induced lung injury (VILI) in patients with acute respiratory distress syndrome. The activation of adenosine A2A receptors has been reported to attenuate inflammatory cascades.
  
  
  OBJECTIVE
  The administration of A2A receptors agonist ameliorates VILI.
  
  
  METHODS
  Rats were subjected to hemorrhagic shock and resuscitation as a first hit to induce systemic inflammation. The animals randomly received the selective A2A receptor agonist CGS-21680 or a vehicle control in a blinded fashion at the onset of resuscitation phase. They were then randomized to receive mechanical ventilation as a second hit with a high tidal volume of 20 mL/kg and zero positive end-expiratory pressure, or a low tidal volume of 6 mL/kg with positive end-expiratory pressure of 5 cm H2O.
  
  
  RESULTS
  The administration of CGS-21680 attenuated lung injury as evidenced by a decrease in respiratory elastance, lung edema, lung injury scores, neutrophil recruitment in the lung, and production of inflammatory cytokines, compared with the vehicle-treated animals.
  
  
  CONCLUSIONS
  The selective A2A receptor agonist may have a place as a novel therapeutic approach in reducing VILI.
authors.affiliation: Department of Intensive Care Medicine and Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Chin-Ming
authors.initials: CM
authors.lastname: Chen
authors.forename: Oscar
authors.initials: O
authors.lastname: Penuelas
authors.forename: Kieran
authors.initials: K
authors.lastname: Quinn
authors.forename: Kuo-Chen
authors.initials: KC
authors.lastname: Cheng
authors.forename: Chien-Feng
authors.initials: CF
authors.lastname: Li
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Slutsky
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D058908:Adenosine A2 Receptor Agonists; D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D008297:Male; D010627:Phenethylamines / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000517:prevention & control*; D055397:Ventilator-Induced Lung Injury / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D058908:Adenosine A2 Receptor Agonists; D016207:Cytokines; D010627:Phenethylamines; C061282:2-(4-(2-carboxyethyl)phenethylamino)-5'-N-ethylcarboxamidoadenosine; D000241:Adenosine