Journal article
AT(1) receptor blocker losartan protects against mechanical ventilation-induced diaphragmatic dysfunction
Journal of applied physiology (1985), Vol.119(10), pp.1033-1041
11/15/2015
DOI: 10.1152/japplphysiol.00237.2015
PMCID: PMC4816409
PMID: 26359481
Abstract
Mechanical ventilation is a life-saving intervention for patients in respiratory failure. Unfortunately, prolonged ventilator support results in diaphragmatic atrophy and contractile dysfunction leading to diaphragm weakness, which is predicted to contribute to problems in weaning patients from the ventilator. While it is established that ventilator-induced oxidative stress is required for the development of ventilator-induced diaphragm weakness, the signaling pathway(s) that trigger oxidant production remain unknown. However, recent evidence reveals that increased plasma levels of angiotensin II (ANG II) result in oxidative stress and atrophy in limb skeletal muscles. Using a well-established animal model of mechanical ventilation, we tested the hypothesis that increased circulating levels of ANG II are required for both ventilator-induced diaphragmatic oxidative stress and diaphragm weakness. Cause and effect was determined by administering an angiotensin-converting enzyme inhibitor (enalapril) to prevent ventilator-induced increases in plasma ANG II levels, and the ANG II type 1 receptor antagonist (losartan) was provided to prevent the activation of ANG II type 1 receptors. Enalapril prevented the increase in plasma ANG II levels but did not protect against ventilator-induced diaphragmatic oxidative stress or diaphragm weakness. In contrast, losartan attenuated both ventilator-induced oxidative stress and diaphragm weakness. These findings indicate that circulating ANG II is not essential for the development of ventilator-induced diaphragm weakness but that activation of ANG II type 1 receptors appears to be a requirement for ventilator-induced diaphragm weakness. Importantly, these experiments provide the first evidence that the Food and Drug Administration-approved drug losartan may have clinical benefits to protect against ventilator-induced diaphragm weakness in humans.
Details
- Title: Subtitle
- AT(1) receptor blocker losartan protects against mechanical ventilation-induced diaphragmatic dysfunction
- Creators
- Oh Sung Kwon - University of FloridaAshley J. Smuder - University of FloridaMichael P. Wiggs - University of FloridaStephanie E. Hall - University of FloridaKurt J. Sollanek - University of FloridaAaron B. Morton - University of FloridaErin E. Talbert - University of FloridaHale Z. Toklu - University of FloridaNihal Tumer - Veterans Health AdministrationScott K. Powers - University of Florida
- Resource Type
- Journal article
- Publication Details
- Journal of applied physiology (1985), Vol.119(10), pp.1033-1041
- DOI
- 10.1152/japplphysiol.00237.2015
- PMID
- 26359481
- PMCID
- PMC4816409
- NLM abbreviation
- J Appl Physiol (1985)
- ISSN
- 8750-7587
- eISSN
- 1522-1601
- Publisher
- Amer Physiological Soc
- Number of pages
- 9
- Grant note
- R01AR064189 / NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS) R01-AR-064189 / National Institute of Arthritis and Musculoskeletal and Skin Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS)
- Language
- English
- Date published
- 11/15/2015
- Academic Unit
- Fraternal Order of Eagles Diabetes Research Center; Health, Sport, and Human Physiology ; Internal Medicine
- Record Identifier
- 9984259395302771
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