Iguidbashian 2022 Changes in infant porcine pulmonary tissue oxylipins.pdf

BACKGROUND: Oxylipins are metabolites derived from fatty acids such as arachidonic acid (AA) and are key mediators in

inflammation, host defense, and tissue injury. Serum oxylipins increase in adults after cardiopulmonary bypass (CPB) but tissue-level

changes are poorly defined. The objective of this study was to characterize pulmonary tissue oxylipins in an infant porcine model of

CPB with deep hypothermic circulatory arrest (DHCA).

METHODS: Infant pigs underwent CPB with DHCA. Controls received anesthesia only. Right upper and lower lobes of the lung

underwent oxylipin analysis via liquid chromatography–tandem mass spectrometry. One-way ANOVA was utilized to assess

differences in oxylipin concentrations across groups, followed by pairwise comparisons.

RESULTS: AA and multiple AA metabolites via cytochrome P450 (CYP450), lipoxygenase (LOX), and cyclooxygenase (COX)

pathways were significantly increased in the upper and lower lobe of pigs exposed to CPB/DHCA as compared to controls. Multiple

prostaglandin metabolites produced via COX were also significantly elevated in the lower lobes of control animals.

CONCLUSIONS: CPB/DHCA induces a significant increase in pulmonary tissue AA, with subsequent metabolism via COX, LOX, and

CYP450 pathways. Interestingly, prostaglandins were also elevated in the lower lobes of the controls, suggesting a mechanism

separate from CPB/DHCA. Future oxylipin studies are needed to better understand CPB-induced acute lung injury.

Pediatric Research (2022) 92:1274–1281; https://doi.org/10.1038/s41390-022-02125-5

IMPACT:

● CPB/DHCA and, to a lesser extent, lung region influence pulmonary tissue-level AA metabolite production.

● Inflammatory mediator AA metabolites have been noted in previous studies to increase following CPB; however, this is the first

study to look at pulmonary tissue-level differences following CPB/DHCA.

● Increases in many AA metabolites, including LOX- and CYP450-derived products, were seen in both upper and lower lobe of

piglets following CPB/DHCA.

● COX-derived prostaglandin metabolites were increased not only in CPB upper and lower lobe but also in mechanically

ventilated control lower lobe, suggesting an additional, separate mechanism from CPB/DCHA.