Orthopedic trauma-induced pulmonary injury in the obese Zucker rat.
OBJECTIVE
Obese subjects with orthopedic trauma exhibit increased inflammation and an increased risk of pulmonary edema. Prostaglandin E(2) (PGE(2) ) production is elevated during inflammation and associated with increased vascular permeability. We hypothesize that pulmonary edema in obesity following orthopedic trauma is due to elevated PGE(2) and resultant increases in pulmonary permeability.


METHODS
Orthopedic trauma was induced in both hindlimbs in lean (LZ) and obese Zucker rats (OZ). On the following day, plasma interleukin-6 (IL-6) and PGE(2) levels, pulmonary edema, and pulmonary gas exchange capability were compared between groups: LZ, OZ, LZ with trauma (LZT), and OZ with trauma (OZT). Vascular permeability in isolated lungs was measured in LZ and OZ before and after application of PGE(2) .


RESULTS
As compared with the other groups, the OZT exhibited elevated plasma IL-6 and PGE(2) levels, increased lung wet/dry weight ratio and bronchoalveolar protein concentration, and an impaired pulmonary gas exchange. Indomethacin treatment normalized plasma PGE(2) levels and pulmonary edema. Basal pulmonary permeability in isolated lungs was higher in OZ than LZ, with a further increase in permeability following treatment with PGE(2) .


CONCLUSIONS
These results suggest that pulmonary edema in OZ following orthopedic trauma is due to an elevated PGE(2) and resultant increases in pulmonary permeability.
Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA. lxiang2@physiology.umsmed.edu
Lusha
L
Xiang
Robert L
RL
Hester
William L
WL
Fuller
Mohamad E
ME
Sebai
Peter N
PN
Mittwede
Elizabeth K
EK
Jones
Arun
A
Aneja
George V
GV
Russell
D000818:Animals; D002199:Capillary Permeability / Q000187:drug effects; D015232:Dinoprostone / Q000097:blood / Q000494:pharmacology; D004195:Disease Models, Animal; D006801:Humans; D066298:In Vitro Techniques; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D055370:Lung Injury / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D009141:Musculoskeletal System / Q000293:injuries*; D009765:Obesity / Q000150:complications*; D011652:Pulmonary Circulation; D011654:Pulmonary Edema / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D011659:Pulmonary Gas Exchange; D051381:Rats; D011924:Rats, Zucker
D018836:Inflammation Mediators; D015850:Interleukin-6; D015232:Dinoprostone