• Thomas Waldow, Wolfgang Witt, Anne Buzin, André Ulmer, and Klaus Matschke.
• Clinic for Cardiac Surgery, University Hospital Dresden, Dresden, Germany.
• J. Surg. Res. 2009 Apr 1; 152 (2): 198-208.

BackgroundPulmonary ischemia/reperfusion (I/R) injury is associated with degradation of structural proteins. Preconditioning by short-term inhalation of nitric oxide (NO) ameliorates some of the severe consequences of an I/R cycle. The aim of this study was to evaluate the effects of NO preconditioning on I/R-induced changes of matrix metalloproteinase (MMP) activity.Materials And MethodsLeft lung in situ ischemia in rats was maintained for 1 h, followed by reperfusion for 30 min or 4 h. In the NO group, animals inhaled NO (15 ppm) for 10 min directly before ischemia. Changes of expression or activity of MMPs (MMP-2, MMP-7, MMP-9, MMP-14) and of neutrophil elastase (NE) in bronchoalveolar lavage fluid (BALF), lung tissue, and arterial plasma were analyzed by zymography and Western blotting. Western blotting was also used to detect tissue inhibitors of matrix proteases, the extracellular metalloproteinase inducer (EMMPRIN or CD147), and endostatin, a proteolytic collagen fragment.ResultsIschemia resulted in an increase of lavagable MMP activity (12.3-fold MMP-2, 8.1-fold MMP-7) at 30 min reperfusion. The activity of MMP-9 and NE in lung tissue progressively increased with time, whereas MMP-14 and MMP-2 were constant. Inhalation of NO prevented the early increase of MMP-2 and MMP-7 in BALF, but the level of MMP-9 and NE in tissue was not affected. The expression of tissue inhibitors of matrix proteases and EMMPRIN did not respond to any treatment. The release of endostatin proceeded in parallel to the level of MMPs in BALF. Significant correlations between MMP-9 and myeloperoxidase in lung tissue and between MMP-2/MMP-7 and plasma protein extravasation were found.ConclusionsThe early rise of MMP-2 and MMP-7 in BALF resulted from plasma protein extravasation, whereas MMP-9 and NE were imported into lung tissue via leukocyte invasion. The effect of NO inhalation on lavagable MMPs was secondary to the sealing of the permeability barrier.

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