Dual immunosuppression enhances vasomotor injury: interactive effect between endothelin-1 and nitric oxide bioavailability

J Thorac Cardiovasc Surg. 2008 Apr;135(4):938-44. doi: 10.1016/j.jtcvs.2007.09.075. Epub 2008 Mar 18.

Abstract

Objective: Cyclosporine A and corticosteroids are associated with many side effects, such as endothelial dysfunction and transplant vasculopathy. We examined the effects of cyclosporine A and hydrocortisone exposure on endothelial function of the rat thoracic aorta.

Methods: Lewis rats were injected with cyclosporine A, hydrocortisone, cyclosporine A + hydrocortisone, or intraperitoneal saline daily for 2 weeks. Endothelial-dependent and independent vascular relaxation were assessed in isolated segments of thoracic aorta, as well as endothelin-1-induced vasoreactivity. Protein expression of endothelial nitric oxide synthase, endothelin(A), and endothelin(B) receptors were also determined in the thoracic aorta.

Results: Exposure to cyclosporine A and cyclosporine A + hydrocortisone resulted in a reduction in endothelial-dependent vasorelaxation compared with control and hydrocortisone (P = .001). Cyclosporine A and hydrocortisone-treated rats demonstrated increased vasoreactivity to endothelin-1 compared with control, whereas cyclosporine A + hydrocortisone treatment resulted in a synergistic increase (P = .04). All treatment groups displayed a significant reduction in endothelial nitric oxide synthase expression compared with control (P = .001). Endothelin(A) receptor expression was increased in all treatment groups with a synergistic effect seen after cyclosporine A + hydrocortisone treatment. No differences were seen in endothelin(B) receptor expression.

Conclusion: Cyclosporine A and hydrocortisone induce vasomotor dysfunction with a synergistic impairment observed after concomitant exposure. Our findings suggest that the resultant vasomotor dysfunction is the result of alterations in both nitric oxide and endothelin-1 regulation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Aorta / drug effects
  • Aorta / physiology
  • Cyclosporine / pharmacology*
  • Endothelin-1 / physiology
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiology
  • Glucocorticoids / pharmacology
  • Hydrocortisone / pharmacology*
  • Immunosuppressive Agents / pharmacology*
  • Male
  • Nitric Oxide / physiology
  • Rats
  • Rats, Inbred Lew
  • Vasodilation / drug effects
  • Vasodilation / physiology

Substances

  • Endothelin-1
  • Glucocorticoids
  • Immunosuppressive Agents
  • Nitric Oxide
  • Cyclosporine
  • Hydrocortisone