ABSTRACT. The physiologic role of endothelin-1 (ET-1) and its receptors in regulating fetal pulmonary vascular tone is unknown. We therefore investigated the role of ET-1 and its receptors in the regulation of fetal pulmonary vascular tone using BQ 123 (an ET, receptor antagonist) and 4 Ala ET-1 (an ETb receptor agonist). In six fetal sheep in utero, we found that injections of ET-1 (250 ng/ kg fetal weight) into the left pulmonary artery increased left pulmonary blood flow (21.0 f 17.5 to 74.7 f 32.9 mL/ kg/min, p < 0.05) and decreased left pulmonary vascular resistance (6.02 f 7.00 to 0.84 f 0.48 mm Hg/kg/min/mL, p c 0.05). BQ 123 (5 mg) increased pulmonary blood flow (24.6 f 28.7 to 47.7 f 27.4 mL/kg/min, p < 0.05) and 1 1, 18). We have previously shown that BQ 123 is a selective ET, antagonist in newborn lambs and inhibits ET-I-induced pulmonary vasoconstriction (8). In contrast to BQ 123,4 Ala ET-1 is a selective ETh agonist that induces pulmonary vasodilation during U44619-induced pulmonary hypertension ( 18).This study had two main objectives. The first was to investigate the role of ET-I and its receptors in the regulation of pulmonary vascular tone in near-term, chronically instrumented fetal sheep in tttero by studying the effects of a selective ET-I receptor antagonist and agonist. The second objective was to investigate the mechanism of the ET-I effect on the pulmonary circulation. For the first objective, we studied the effects of injections of ET-1 and 4 Ala ET-I into the left pulmonary artery and inferior vena cava and infusions of BQ 123 into the left pulmonary artery on fetal pulmonary vascular tone. For the second objective, we compared the hemodynamic effects of exogenous ET-1 before and during the infusion of glibenclamide (an ATP-dependent potassium channel blocker).
MATERIALS AND METHODSSztrgical preparation. Fetal surgery was performed as previously described (19). Briefly, a total of six Western fetal sheep were studied at 135.8 k 6.1 d gestational age (term 145 d). The ewe was anesthetized with an epidural injection of 4 mL of I % tetracaine hydrochloride. Polyvinyl catheters were inserted into the maternal pedal vein and artery after local infiltration with 2% lidocaine hydrochloride.With use of aseptic techniques, the uterus was exposed through a midline incision. Through a small uterine incision the hind limb was exposed, and polyvinyl catheters were inserted into the fetal wdal vein and artery and their tips advanced to the descend- Polyvinyl catheters were then inserted into the internal thoracic