Background-Endothelin-1 (ET-1) has been implicated in the pathophysiology of pulmonary hypertension. In 1-monthold lambs with increased pulmonary blood flow, we have demonstrated early alterations in the ET-1 cascade. The objective of this study was to investigate the role of potential later alterations of the ET cascade in the pathophysiology of pulmonary hypertension secondary to increased pulmonary blood flow. Methods and Results-Eighteen fetal lambs underwent in utero placement of an aortopulmonary vascular graft (shunt) and were studied 8 weeks after spontaneous delivery. Compared with age-matched control lambs, lung tissue ET-1 levels were increased in shunt lambs (317.2Ϯ113.8 versus 209.8Ϯ61.8 pg/g, PϽ0.05). In shunt lambs (nϭ9), exogenous ET-1 induced potent pulmonary vasoconstriction, which was blocked by the ET A receptor antagonist PD 156707 (nϭ3). This pulmonary vasoconstriction was mimicked by exogenous Ala 1,3,11,15 ET-1 (4 Ala ET-1), the ET B receptor agonist, and was blocked by the ET B receptor antagonist BQ 788 (nϭ3). However, in control lambs (nϭ7), ET-1 and 4 Ala ET-1 did not change pulmonary vascular tone. In contrast to 4-week-old shunt lambs, immunohistochemistry revealed the emergence of ET B receptors on smooth muscle cells in the vasculature of 8-week-old shunt lambs.
Conclusions-Over