Inhibitory effects of diclofenac on the endotoxin shock response in relation to endothelin turnover in the pig

Acta Anaesthesiol Scand. 1995 Jan;39(1):50-9. doi: 10.1111/j.1399-6576.1995.tb05592.x.

Abstract

During sepsis vasoactive arachidonic acid metabolites of the cyclo-oxygenase pathway and the endothelium-derived vasoconstrictor endothelin-1 (ET-1) are released. The effects of cyclo-oxygenase pathway inhibition by diclofenac on the endotoxin shock response and ET-1 turnover, were investigated in five groups of pigs. In the first group (n = 7; controls) endotoxin (15 micrograms.kg-1.h-1 i.v.) was infused for two hours. In a second endotoxin group (n = 7), the animals were pretreated with diclofenac (3 mg.kg-1 i.v.). In a third group (n = 7), high-dose ET-1 was infused (20 pmol.kg-1.min-1 i.v.) and in a fourth group (n = 7), the ET-1 infusion was preceded by diclofenac. In a fifth group (n = 4), a low and intermediate dose of ET-1 (0.2 and 4 pmol.kg-1.min-1) was infused. A significant increase in ET-1-like immunoreactivity (LI) plasma levels was observed in both endotoxin groups, but in the diclofenac group the increase was comparatively delayed. Furthermore, this group showed a more stable haemodynamic course and in the biphasic increase of pulmonary vascular resistance seen in endotoxin controls, the initial peak was abolished by diclofenac. Exogenous ET-1 infusion indicated that not only locally released but possibly also circulating ET-1 could be a mediator of vascular responses to endotoxin. Indications of release from the lungs were seen during endotoxin infusion. Diclofenac had no effect on basal ET-1-LI plasma levels or on the disappearance rate from plasma of ET-1-LI and the haemodynamic changes seen on ET-1 infusion. The inhibition of cyclo-oxygenase pathway by diclofenac resulted in prevention of the initial pulmonary hypertension and a delayed increase in plasma ET-1-LI levels in porcine endotoxin shock and this latter effect is not due to an increased rate of disappearance from plasma but rather to a decreased release of ET-1.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Arachidonic Acids / metabolism
  • Blood Pressure / drug effects
  • Cardiac Output / drug effects
  • Cyclooxygenase Inhibitors / pharmacology
  • Diclofenac / pharmacology*
  • Endothelins / administration & dosage
  • Endothelins / blood
  • Endothelins / metabolism*
  • Endothelins / pharmacology
  • Endotoxins / adverse effects*
  • Endotoxins / antagonists & inhibitors
  • Escherichia coli*
  • Heart Rate / drug effects
  • Hypertension, Pulmonary / prevention & control
  • Lipopolysaccharides / adverse effects
  • Lipopolysaccharides / antagonists & inhibitors
  • Lung / blood supply
  • Lung / metabolism
  • Neuropeptide Y / blood
  • Norepinephrine / blood
  • Shock, Septic / metabolism*
  • Shock, Septic / physiopathology
  • Swine
  • Vascular Resistance / drug effects

Substances

  • Arachidonic Acids
  • Cyclooxygenase Inhibitors
  • Endothelins
  • Endotoxins
  • Lipopolysaccharides
  • Neuropeptide Y
  • Diclofenac
  • Norepinephrine