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Am. J. Respir. Crit. Care Med., Volume 156, Number 1, July 1997, 280-285

Endothelin-1 Production during the Acute Chest Syndrome in Sickle Cell Disease

SAMUEL I. HAMMERMAN, STELLA KOUREMBANAS, TAMMY J. CONCA, MARISA TUCCI, MARK BRAUER, and HARRISON W. FARBER

Pulmonary Center and Division of Hematology, Boston University School of Medicine, Boston; Joint Program in Neonatology, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts

To investigate the role of the endothelial-derived vasoactive mediator endothelin (ET-1) in the acute chest syndrome (ACS), we incubated bovine pulmonary artery endothelial cells (BPAEC) with red blood cells (equivalent to a hematocrit of 20%) and/or autologous plasma (1:10 dilution) from two patients during ACS and during routine clinic visits. Cellular RNA was analyzed for ET-1 transcripts by Northern analysis and ET-1 protein levels in BPAEC supernatants and in plasma measured by radioimmunoassay. ET-1 mRNA expression and protein levels increased in BPAEC exposed to plasma obtained during ACS; in contrast, exposure to plasma obtained during routine clinic visits did not alter BPAEC ET-1 mRNA expression or protein levels. Plasma ET-1 level was elevated during ACS, decreased during resolution, and remained slightly elevated during routine clinic visits. Plasma obtained from one patient 4 d prior to hospitalization for vasoocclusive crisis contained the highest ET-1 level and markedly increased BPAEC ET-1 mRNA expression and protein levels. In both patients, BPAEC ET-1 mRNA and protein expression in vitro and plasma ET-1 levels in vivo correlated with stage of disease and occurred in the absence of direct erythrocyte contact in vitro. These observations suggest that ET-1 production contributes to development of ACS.




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