Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0242706 (hyperoxia)
 5,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although oxygen therapy has been used in the care of critically ill patients for many years, the recognition of pulmonary oxygen toxicity as an important clinical problem is relatively recent. The biochemical basis of oxygen toxicity is increased production of highly reactive, partially reduced metabolites of oxygen, including hydrogen peroxide and free radicals, by cells in hyperoxia. Enzymatic intracellular defense mechanisms exist which protect cells from the toxic effects of oxygen free radicals. The physiologic manifestations of oxygen toxicity include decreases in vital capacity, diffusing capacity, and lung compliance. The pathologic changes of oxygen toxicity are not specific and resemble those of the adult respiratory distress syndrome. Many drugs used in the care of patients, including bleomycin, nitrofurantoin, and corticosteroids, may exacerbate oxygen-induced lung injury. No effective pharmacologic means exist for lessening pulmonary oxygen toxicity in humans.
 ...
PMID:Pulmonary oxygen toxicity. 390 87

The low rate of survival in patients with the adult respiratory distress syndrome (ARDS) may in part reflect a failure to consider that the lung's response to applied therapies may not be constant throughout the course of illness. To test this notion, we used hyperoxia to produce progressive lung damage in rats and administered dexamethasone at different times during O2 exposures of various lengths. Dexamethasone improved survival and decreased lung damage if given when exposure to hyperoxia was to be soon terminated; pulmonary inflammation was marked at the time at which the administration of dexamethasone led to increased survival. Dexamethasone worsened lung damage and diminished survival when given early during exposure to hyperoxia; inflammation was minimal early in the course of exposure to hyperoxia. These findings point to the need for a more analytical approach to research on therapy of ARDS; agents that are harmful at one time may be beneficial at another time.
 ...
PMID:Oxygen toxicity in rats. Varied effect of dexamethasone treatment depending on duration of hyperoxia. 400 43

The efficacy of alpha-tocopherol treatment to influence the pattern or extent of lung injury resulting during exposure of newborn rats to hyperoxia was assessed following six-day exposures to FIO2 0.21, 0.4, and greater than 0.95. Alpha-Tocopherol treatment was found incapable of preventing the developmental arrest of the lung that occurs during hyperoxic exposure, shown by assessments of wet lung weights, lung DNA, lung volumes, and the progress of secondary septal and capillary development. However alpha-tocopherol treatment was found effective in preventing the hyperoxic-induced lessening of lung compliance and in preventing the deterioration of gas exchange capacity in the lung of the hyperoxic-exposed newborn rat. These findings suggest alpha-tocopherol treatment may not be capable of preventing major alterations in lung morphology in infants with chronic lung disease may be lessened by preserving gas exchange capabilities.
 ...
PMID:Effects of alpha-tocopherol treatment on newborn rat lung development and injury in hyperoxia. 711 Jul 51

In order to determine if lungs with emphysema respond to oxygen toxicity in a different way from normal lungs, the effects of hyperoxia on pulmonary function, morphologic aspects, and survival were studied in rats with enzyme-induced emphysema. A hyperoxic pulmonary syndrome similar to adult respiratory distress syndrome (ARDS) was produced by a continuous 48-h exposure to 100% oxygen at 1 atm. An emphysematous condition was induced by intratracheal instillation of porcine pancreatic elastase. The 4 study groups consisted of (1) control, (2) oxygen-treated, (3) elastase-treated, and (4) combined oxygen-elastase-treated rats. The emphysematous rats exposed to 100% O2 had reductions in quasi-static compliance and CO diffusing capacity similar to those in oxygen-treated normal animals. They also had reductions in forced expiratory volumes and flow rates similar to those in rats treated with elastase alone. Histologically, there was no enhancement or attenuation of emphysematous or ARDS lesions in the combined oxygen-elastase lungs compared with that in lungs treated with only one agent. Emphysematous and normal rats were also exposed for 96 h to a similar hyperoxic atmosphere to evaluate survival. The survival curves for these 2 groups were not statistically different. These results indicate that the severity of ARDS alterations was not affected by the emphysematous condition, and hyperoxia did not enhance or attentuate preexisting emphysematous lesions. These findings suggest that emphysematous lungs respond to hyperoxia in a similar fashion to normal lungs, and that the functional and structural manifestations of oxygen toxicity are simply superimposed over preexisting emphysematous changes.
 ...
PMID:The effects of emphysema on oxygen toxicity in rats. 718 Dec 25

Animals and humans rapidly develop respiratory failure and die within a few days when exposed to 100% oxygen. Postmortem examination of the lungs shows histopathologic features characteristic of diffuse alveolar damage, clinically recognized as adult respiratory distress syndrome (ARDS). At the present time, there is no effective therapy available to alter outcomes in ARDS. Importantly, hypomagnesemia also is frequently observed in critically ill patients at risk of developing ARDS. In a model of hyperoxic lung injury, rats were exposed to 100% oxygen for 48, 64, and 96 hr and several experiments were performed. First, changes in the features of bronchoalveolar lavage and in alveolar macrophage function were compared in rats exposed to room air and those exposed to hyperoxia. Second, we studied the effect of hypomagnesemia on the severity of hyperoxic lung injury. Third, we evaluated the pulmonary responses to high-dose and normal-dose Mg therapy in rats exposed to hyperoxia. In all groups, hyperoxia induced significant changes in the total and differential cell counts with increased lipid peroxidation of lavaged cells, enhanced chemiluminescence from alveolar macrophages, and protein leakage into the alveolar spaces. After 48 hr of hyperoxia, oxygen-free radical formation and hydrogen peroxide production by the alveolar macrophage were diminished compared to baseline, implying a toxic effect of hyperoxia on the alveolar macrophages. Overall, hypomagnesemia tended to magnify the degree of hyperoxic lung injury, while high-dose Mg therapy tended to attenuate the effects of hyperoxia. In conclusion, in this animal model of diffuse alveolar damage, alterations in host serum magnesium levels may modulate the degree of lung damage.
 ...
PMID:Pulmonary response to hyperoxia: effects of magnesium. 770 82

Activated alveolar macrophages and epithelial type II cells release both nitric oxide and superoxide which react at near diffusion-limited rate (6.7 x 10(9) M-1s-1) to form peroxynitrite, a potent oxidant capable of damaging the alveolar epithelium and pulmonary surfactant. Peroxynitrite, but not nitric oxide or superoxide, readily nitrates phenolic rings including tyrosine. We quantified the presence of nitrotyrosine in the lungs of patients with the adult respiratory distress syndrome (ARDS) and in the lungs of rats exposed to hyperoxia (100% O2 for 60 h) using quantitative immunofluorescence. Fresh frozen or paraffin-embedded lung sections were incubated with a polyclonal antibody to nitrotyrosine, followed by goat anti-rabbit IgG coupled to rhodamine. Sections from patients with ARDS (n = 5), or from rats exposed to hyperoxia (n = 4), exhibited a twofold increase of specific binding over controls. This binding was blocked by the addition of an excess amount of nitrotyrosine and was absent when the nitrotyrosine antibody was replaced with nonimmune IgG. In additional experiments we demonstrated nitrotyrosine formation in rat lung sections incubated in vitro with peroxynitrite, but not nitric oxide or reactive oxygen species. These data suggest that toxic levels of peroxynitrite may be formed in the lungs of patients with acute lung injury.
 ...
PMID:Quantitation of nitrotyrosine levels in lung sections of patients and animals with acute lung injury. 798 97

Surfactant dysfunction contributes to the pathophysiology of adult respiratory distress syndrome (ARDS), and we hypothesized that surfactant treatment would improve experimental ARDS produced by continuous exposure to hyperoxia. Twelve healthy male baboons (10-15 kg) were anesthetized, paralyzed, and mechanically ventilated with 2.5 cmH2O positive end-expiratory pressure (PEEP) for 96 h. Baboons were divided into three groups: 1) the O2 group (n = 5) received 100% O2, 2) the surfactant group (n = 5) received 100% O2 and aerosolized porcine surfactant, and 3) a control group (n = 2) was ventilated at fractional concentration of inspired O2 of 0.21 for 96 h to control for effects of anesthesia and mechanical ventilation. Hemodynamic parameters were obtained every 12 h, and ventilation-perfusion (VA/Q) distribution was measured daily by multiple inert gas elimination technique. PEEP was increased once or twice daily to 10 cmH2O for 30 min to study its effects on measurements of VA/Q. At the end of experiments, lungs were obtained for biochemical analysis. Prolonged hyperoxia resulted in progressive worsening in VA/Q, hemodynamic deterioration, severe lung edema, and altered surfactant metabolism. Surfactant administration increased disaturated phosphatidylcholine in lavage fluid but did not improve lung edema or gas exchange. In the surfactant group, however, the addition of 10 cmH2O PEEP resulted in a greater degree of shunt reduction than did 2.5 cmH2O PEEP (47 vs. 31% in the O2 group, P < 0.05). We conclude that aerosolized porcine surfactant did not prevent pulmonary O2 injury in baboons, but it potentiated the shunt-reducing effect of PEEP.
 ...
PMID:Natural surfactant and hyperoxic lung injury in primates. I. Physiology and biochemistry. 800 91

Oxygen therapy is administered to decrease tissue hypoxia and to relieve arterial hypoxemia. High concentrations of oxygen are often used in patients with adult respiratory distress syndrome. Supplying oxygen to animals has been known to produce tissue damage, with toxicity increasing with the increase of oxygen concentrations and exposure pressures. End-organ damage from hyperoxia depends on both the concentration of oxygen administered and the oxygen pressure during exposure. Prolonged exposure to hyperbaric oxygen causes central nervous system and pulmonary toxicity, which results in atelectasis, pulmonary edema, and seizures. Lung damage may occur as a result of normobaric hyperoxia. A severe retinopathy (retrolental fibroplasia) occurs in neonates during oxygen exposures. For all of these reasons, the lowest possible concentration of oxygen that relieves tissue hypoxia is recommended in patients with adult respiratory distress syndrome.
 ...
PMID:Oxygen toxicity. 808 71

Most survivors of ARDS have persistent mild reductions of TLCO even as long as a year after their episode. The lung volumes and flows return to normal in most instances, although a subset of patients will have persistent impairment. Both obstructive and restrictive deficits may be seen. This group may be predicted by the degree of acute lung injury assessed by the level of FIO2, PEEP, and gas exchange abnormality that exists in the first few days. In the first year after ARDS most physiological abnormalities will improve, but if deficits persist at one year further improvement is unlikely. Although many patients report dyspnoea following ARDS, the symptom does not correlate with abnormalities of pulmonary function. The possibility that conventional management may augment the degree of acute injury and worsen outcome must be considered. The effects of chronic hyperoxia in humans with acute lung injury or those of high levels of PEEP compared with low levels are not known. Exploring new ventilator management strategies while we await more specific treatment directed at the primary problem of acute lung inflammation will hopefully reduce acute mortality as well as acute and chronic morbidity.
 ...
PMID:Sequelae of the adult respiratory distress syndrome. 815 46

Previously we have shown that a group of patients treated for iron overdose with prolonged deferoxamine (DFO) infusion died of adult respiratory distress syndrome (ARDS). We now describe a model to investigate the mechanism of this pulmonary toxicity. Mice treated with 1 oral dose of iron (Fe) and then multiple injections of DFO, or with the chelated product ferrioxamine alone, did not develop lung lesions, even at doses which induced mortality. To potentiate any possible free radical reaction, other groups of mice were treated similarly while exposed to 75-80% O2 over a 4-day period. Ten of 12 mice receiving 0.75 mg Fe and then DFO (10 mg, 4 times/day for 4 days) with hyperoxia died suddenly. At autopsy the lungs were dark red and solid; sections showed hyaline membranes and alveolar exudates of edema, fibrin, and PMN. Electron microscopy showed massive destruction of the alveolar epithelium; using cerium chloride, a free radical reaction product was demonstrated at the alveolar surface. Lung lavage fluid contained 10-12 x normal levels of protein when the Fe-DFO-O2 group was compared to air or O2 controls. Mice receiving DFO or Fe, plus O2, showed only slight injury and a small increase in alveolar protein. The results indicate that Fe plus DFO generates free radicals in the lung, a reaction potentiated by hyperoxia to produce an ARDS-like picture. This suggests that the pulmonary toxicity of DFO in iron-poisoned patients is due to its prooxidant activity resulting in free radical destruction of the airblood barrier.
 ...
PMID:Pulmonary toxicity of deferoxamine in iron-poisoned mice. 851 75


<< Previous 1 2 3 4 5 Next >>