Packed red cell transfusions alter mesenteric arterial reactivity and nitric oxide pathway in preterm lambs

Jayasree Nair, Sylvia F. Gugino, Lori C. Nielsen, Cheryl Allen, James A. Russell, Bobby Mathew, Daniel D. Swartz, Satyanarayana Lakshminrusimha

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Cases of necrotizing enterocolitis occurring within 48 h of packed red blood cell (PRBC) transfusions are increasingly being described in observational studies. Transfusion-associated gut injury is speculated to result from an abnormal mesenteric vascular response to transfusion. However, the mechanism of disruption of the balance between mesenteric vasoconstriction and relaxation following transfusion is not known. Methods: Preterm lambs (n = 16, 134 d gestation; term: 145-147 d) were delivered and ventilated for 24 h. All the lambs received orogastric feeds with colostrum. In addition, 10 of these lambs received PRBC transfusions. Vasoreactivity was evaluated in isolated mesenteric arterial rings using norepinephrine and endothelin-1 as vasoconstrictors. Endothelium-dependent (A23187, a calcium ionophore) and endothelium-independent (SNAP) nitric oxide (NO) donors were used as vasorelaxants. Mesenteric arterial endothelial NO synthase (eNOS), soluble guanylyl cyclase (sGC), and phosphodiesterase 5 (PDE5) mRNA analyses and protein assays were performed. Results: Transfusion with PRBC significantly increased mesenteric vasoconstriction to norepinephrine and endothelin-1 and impaired relaxation to A23187 and SNAP. Mesenteric arterial eNOS protein decreased following PRBC transfusion. No significant changes were noted in sGC and PDE5 mRNA or protein assays. Conclusion: PRBC transfusion in enterally fed preterm lambs promotes mesenteric vasoconstriction and impairs vasorelaxation by reducing mesenteric arterial eNOS.

Original languageEnglish (US)
Pages (from-to)652-657
Number of pages6
JournalPediatric Research
Volume74
Issue number6
DOIs
StatePublished - Dec 1 2013
Externally publishedYes

Fingerprint

Erythrocyte Transfusion
Nitric Oxide
Vasoconstriction
Type 5 Cyclic Nucleotide Phosphodiesterases
Calcimycin
Endothelin-1
Nitric Oxide Synthase
Endothelium
Norepinephrine
Necrotizing Enterocolitis
Messenger RNA
Colostrum
Proteins
Nitric Oxide Donors
Calcium Ionophores
Nitric Oxide Synthase Type III
Vasoconstrictor Agents
Vasodilator Agents
Vasodilation
Observational Studies

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Packed red cell transfusions alter mesenteric arterial reactivity and nitric oxide pathway in preterm lambs. / Nair, Jayasree; Gugino, Sylvia F.; Nielsen, Lori C.; Allen, Cheryl; Russell, James A.; Mathew, Bobby; Swartz, Daniel D.; Lakshminrusimha, Satyanarayana.

In: Pediatric Research, Vol. 74, No. 6, 01.12.2013, p. 652-657.

Research output: Contribution to journalArticle

Nair, Jayasree ; Gugino, Sylvia F. ; Nielsen, Lori C. ; Allen, Cheryl ; Russell, James A. ; Mathew, Bobby ; Swartz, Daniel D. ; Lakshminrusimha, Satyanarayana. / Packed red cell transfusions alter mesenteric arterial reactivity and nitric oxide pathway in preterm lambs. In: Pediatric Research. 2013 ; Vol. 74, No. 6. pp. 652-657.
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AU - Nair, Jayasree

AU - Gugino, Sylvia F.

AU - Nielsen, Lori C.

AU - Allen, Cheryl

AU - Russell, James A.

AU - Mathew, Bobby

AU - Swartz, Daniel D.

AU - Lakshminrusimha, Satyanarayana

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N2 - Background: Cases of necrotizing enterocolitis occurring within 48 h of packed red blood cell (PRBC) transfusions are increasingly being described in observational studies. Transfusion-associated gut injury is speculated to result from an abnormal mesenteric vascular response to transfusion. However, the mechanism of disruption of the balance between mesenteric vasoconstriction and relaxation following transfusion is not known. Methods: Preterm lambs (n = 16, 134 d gestation; term: 145-147 d) were delivered and ventilated for 24 h. All the lambs received orogastric feeds with colostrum. In addition, 10 of these lambs received PRBC transfusions. Vasoreactivity was evaluated in isolated mesenteric arterial rings using norepinephrine and endothelin-1 as vasoconstrictors. Endothelium-dependent (A23187, a calcium ionophore) and endothelium-independent (SNAP) nitric oxide (NO) donors were used as vasorelaxants. Mesenteric arterial endothelial NO synthase (eNOS), soluble guanylyl cyclase (sGC), and phosphodiesterase 5 (PDE5) mRNA analyses and protein assays were performed. Results: Transfusion with PRBC significantly increased mesenteric vasoconstriction to norepinephrine and endothelin-1 and impaired relaxation to A23187 and SNAP. Mesenteric arterial eNOS protein decreased following PRBC transfusion. No significant changes were noted in sGC and PDE5 mRNA or protein assays. Conclusion: PRBC transfusion in enterally fed preterm lambs promotes mesenteric vasoconstriction and impairs vasorelaxation by reducing mesenteric arterial eNOS.

AB - Background: Cases of necrotizing enterocolitis occurring within 48 h of packed red blood cell (PRBC) transfusions are increasingly being described in observational studies. Transfusion-associated gut injury is speculated to result from an abnormal mesenteric vascular response to transfusion. However, the mechanism of disruption of the balance between mesenteric vasoconstriction and relaxation following transfusion is not known. Methods: Preterm lambs (n = 16, 134 d gestation; term: 145-147 d) were delivered and ventilated for 24 h. All the lambs received orogastric feeds with colostrum. In addition, 10 of these lambs received PRBC transfusions. Vasoreactivity was evaluated in isolated mesenteric arterial rings using norepinephrine and endothelin-1 as vasoconstrictors. Endothelium-dependent (A23187, a calcium ionophore) and endothelium-independent (SNAP) nitric oxide (NO) donors were used as vasorelaxants. Mesenteric arterial endothelial NO synthase (eNOS), soluble guanylyl cyclase (sGC), and phosphodiesterase 5 (PDE5) mRNA analyses and protein assays were performed. Results: Transfusion with PRBC significantly increased mesenteric vasoconstriction to norepinephrine and endothelin-1 and impaired relaxation to A23187 and SNAP. Mesenteric arterial eNOS protein decreased following PRBC transfusion. No significant changes were noted in sGC and PDE5 mRNA or protein assays. Conclusion: PRBC transfusion in enterally fed preterm lambs promotes mesenteric vasoconstriction and impairs vasorelaxation by reducing mesenteric arterial eNOS.

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