Na, K-ATPase gene transfer increases liquid clearance during ventilation-induced lung injury

Y Adir, P Factor, V Dumasius, KM Ridge… - American journal of …, 2003 - atsjournals.org
Y Adir, P Factor, V Dumasius, KM Ridge, JI Sznajder
American journal of respiratory and critical care medicine, 2003atsjournals.org
Mechanical ventilation with high tidal volumes (HVT) downregulates alveolar Na, K-ATPase
function and impairs lung liquid clearance. We hypothesized that overexpression of Na, K-
ATPase in the alveolar epithelium could counterbalance these changes and increase
clearance in a rat model of mild ventilation-induced lung injury. We used a surfactant-based
system to deliver 4× 109 plaque-forming units of E1a−/E3− recombinant adenovirus
containing either a rat β1 Na, K-ATPase subunit cDNA (adβ1) or no cDNA (adnull) to rat …
Mechanical ventilation with high tidal volumes (HVT) downregulates alveolar Na,K-ATPase function and impairs lung liquid clearance. We hypothesized that overexpression of Na,K-ATPase in the alveolar epithelium could counterbalance these changes and increase clearance in a rat model of mild ventilation-induced lung injury. We used a surfactant-based system to deliver 4 × 109 plaque-forming units of E1a/E3 recombinant adenovirus containing either a rat β1 Na,K-ATPase subunit cDNA (adβ1) or no cDNA (adnull) to rat lungs 7 days before ventilation with a VT of approximately 40 ml/kg (peak airway pressure of less than 35 cm H2O) for 40 minutes. Lung liquid clearance and Na, K-ATPase activity and protein abundance were increased in HVT adβ1-infected lungs as compared with sham and adnull-infected HVT lungs. These results suggest that Na,K-ATPase subunit gene overexpression in the alveolar epithelium increases Na,K-ATPase function and lung liquid clearance in a model of HVT. We provide here the first evidence that using a genetic approach improves active Na+ transport and thus liquid clearance in the setting of mild ventilation-induced lung injury.
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