title: Adenosine A₂A agonist improves lung function during ex vivo lung perfusion.
abstract: BACKGROUND
  Ex vivo lung perfusion (EVLP) is a novel technique than can be used to assess and potentially repair marginal lungs that may otherwise be rejected for transplantation. Adenosine has been shown to protect against pulmonary ischemia-reperfusion (IR) injury through its A(2A) receptor. We hypothesized that combining EVLP with adenosine A(2A) receptor agonist treatment would enhance lung functional quality and increase donor lung use.
  
  
  METHODS
  Eight bilateral pig lungs were harvested and flushed with cold Perfadex (Vitrolife, Englewood, CO). After 14 hours of storage at 4°C, EVLP was performed for 5 hours on 2 explanted lung groups: (1) control group lungs (n = 4) were perfused with Steen Solution (Vitrolife) and dimethyl sulfoxide and (2) treated group lungs (n = 4) received 10 μM CGS21680, a selective A(2A) receptor agonist, in a Steen solution-primed circuit. Lung histologic features, tissue cytokines, gas analysis, and pulmonary function were compared between groups.
  
  
  RESULTS
  Treated lungs demonstrated significantly less edema as reflected by wet-dry weight ratio (6.6 versus 5.2; p < 0.03) and confirmed by histologic examination. In addition, treated lung demonstrated significantly lower levels of interferon-γ (IFN- γ) (45.1 versus 88.5; p < 0.05). Other measured tissue cytokine levels (interleukin [IL]-1β, IL-6, and IL-8) were lower in the treatment group, but values failed to reach statistical significance. The oxygenation index was improved in the treated group (1.5 versus 2.3; p < 0.01) as was mean airway pressure (10.3 versus 13; p < 0.009).
  
  
  CONCLUSIONS
  Combined use of adenosine A(2A) agonist and EVLP significantly attenuates the inflammatory response in acutely injured lungs after IR and enhances pulmonary function. This combination may improve donor lung quality and could increase the donor lung pool for transplantation.
authors: Department of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia, USA.
authors: Abbas
authors: A
authors: Emaminia
authors: Damien J
authors: DJ
authors: Lapar
authors: Yunge
authors: Y
authors: Zhao
authors: John F
authors: JF
authors: Steidle
authors: David A
authors: DA
authors: Harris
authors: Victor E
authors: VE
authors: Laubach
authors: Joel
authors: J
authors: Linden
authors: Irving L
authors: IL
authors: Kron
authors: Christine L
authors: CL
authors: Lau
mesh_terms: D058908:Adenosine A2 Receptor Agonists / Q000627:therapeutic use*; D000818:Animals; D066298:In Vitro Techniques; D008168:Lung / Q000502:physiology*; D016040:Lung Transplantation; D010477:Perfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000517:prevention & control*; D013552:Swine
chemical_list: D058908:Adenosine A2 Receptor Agonists