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Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104
Mechanical ventilation with high
tidal volumes has been shown to contribute to the formation or
worsening of interstitial and alveolar edema. Previously we showed that
application of large biaxial deformations in vitro perturbs the
concentration and distribution of functional tight junction proteins in
alveolar epithelial cells. Using a novel method, we determined that
applied epithelial strain increases paracellular permeability in a
dose- and rate-dependent manner. Primary rat alveolar epithelial cells
were subjected to 12%, 25%, or 37% change in surface area (
SA)
cyclic equibiaxial stretch for 1 h. Cells were also stretched
noncyclically at 25%
SA for 1 h. During the experimental
period, a fluorescently tagged ouabain derivative was added to the
apical fluid. Evidence of binding indicated functional failure of the
paracellular transport barrier. The percentage of field area stained
was quantified from microscopic images. There was no significant
evidence of basolateral fluorescent staining at 12%
SA or at 25%
SA applied cyclically or statically. However, cyclic stretch at 37%
SA resulted in significantly more staining than in unstretched cells
(P < 0.0001) or those stretched at either 12%
(P < 0.0001) or 25% cyclic (P < 0.0005) or static (P < 0.05)
SA. These results
suggest that large cyclic tidal volumes may increase paracellular
permeability, potentially resulting in alveolar flooding.
injury; lung; transport
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