ABSTRACT. Platelet-activating factor causes pulmonary hypertension, shock, hypoxemia, neutropenia, and increased pulmonary vascular permeability; some of its effects are due to thromboxane Az release. Evidence for a possible role of these mediators in the genesis of group B Streptococcus (GBS)-induced pulmonary hypertension was sought using specific receptor antagonists for PAF and thromboxane Az (TxA2) in anesthetized, ventilated piglets (5 12 d of age; n = 22). Infusion of 1 x 10' GBS/kg/min for one hour resulted in a sustained and significant increase in pulmonary artery pressure (PpA) from 17 & 1 to 35 2 3 torr. Pretreatment with the TxA2 antagonist S Q 29548 (0.75 mg/kg intravenous), completely inhibited the effect of GBS on PpA. Pretreatment with either platelet-activating factor antagonists SRI 63072 (3 mg/kg intravenous) or SRI 63441 (1 mg/kg) did not affect the pulmonary hypertension due to GBS infusion. GBS-induced pulmonary hypertension could be reversed by S Q 29548; SRI 63072 did not affect PpA when administered to pigs with GBS-induced elevation in PpA. Inasmuch as prevention and reversal of GBS-induced pulmonary hypertension are accomplished with the TxAz antagonist but not with PAF antagonists, these data suggest that TxA2, rather than PAF, is responsible for the early pulmonary hypertension in this model of neonatal GBS sepsis. Therefore, TxA2 antagonists may be clinically useful in treating pulmonary hypertension related to GBS sepsis. (Pediatr Res 26: 420-424, 1989) Abbreviations GBS, group B Streptococcus SHETE, 5-hydroxyeicosatetraenoic acid PAF, platelet-activating factor PpA, pulmonary artery pressure TxA2, thromboxane AzIn the human neonate, GBS septicemia is associated with pulmonary hypertension, shock, hypoxemia, granulocytopenia, and a high mortality rate, despite antibiotic therapy (1). The pathophysiology of the clinical syndrome has been reproduced in animal models by infusion of live or heat-killed GBS or its endotoxins (2-4). Inflammatory mediators implicated in the early phase responses to endotoxemia (pulmonary hypertension Received March 14, 1988; accepted June 13, 1989. Correspondence Dr. Bruce R. Pitt, Department of Pharmacology, University of Pittsburgh School of Medicine, Pittsburgh, PA 1526 1.Supported in part by NIH Grant HL-32154 and HL-13315, as well as postdoctoral training support Grant HL-07410. This work was done during the tenure of B.R.P. as an Established Investigator of the American Heart Assocation. and hypoxemia) include cyclooxygenase products [TxA2 (5-9)], and leukotrienes (1 1). Lipoxygenase products [5-HETE, 12-HETE, leukotrienes C4 and D4 (lo)] may also play a role in the pathogenesis of the late phase pulmonary vascular injury and increased permeability. TxA2 and leukocytes appear to be important mediators of the pulmonary dysfunction induced by GBS toxin in lambs (33).PAF is an autocoid phospholipid mediator with a basic structure of 1-O-alkyl-2-acetyl-sn-glycero-3-phosphorylcholine. Its cellular sources include endothelial cells, platelets, neutrop...