Increases in free radicals are believed to play a central role in the development of pulmonary ischemia/reperfusion (I-R) injury, leading to microvascular leakage and deterioration of pulmonary surfactant. Continued ventilation during ischemia offers significant protection against I-R injury, but the impact of alveolar oxygen supply both on lung injury and on radical generation is still unclear. We investigated the influence of hyperoxic (95% O-2) and anoxic (0% O-2) ventilation during ischemia on alveolar antioxidant status and surfactant properties in isolated rabbit lungs. Normoxic and hyperoxic ventilated, buffer-perfused lungs (n = 5, or 6) and native lungs (n = 6) served as controls. As compared with controls, biophysical and biochemical surfactant properties were not altered in anoxic as well as hyperoxic ventilated ischemic (2, 3, and 4 h) lungs. Assessment of several antioxidants (reduced glutathione (GSH), alpha-tocopherol (vitamin E), retinol (vitamin A), ascorbic acid (vitamin Q, uric acid, and plasmalogens (1-O-alkenyl-2-acylphospholipids)) in bronchoalveolar lavage fluid (BALF) revealed a significant increase in antioxidant compounds under anoxic and hyperoxic ventilation, with maximum levels occuring after 3 h of ischemia. For example, GSH increased to 5.1 +/- 0.8 muM (mean SE, p < .001) after 3 h of anoxic ventilated ischemia and to 2.7 +/- 0.2 muM (p < .01) after hyperoxic ventilated ischemia compared with native controls (1.3 +/- 0.2 muM), but did not significantly change under anoxic and hyperoxic ventilation alone. In parallel, under ischemic conditions, oxidized glutathione (GSSG) increased during hyperoxic (3 h: 0.81 +/- 0.04 muM, p < .001), but remained unchanged during anoxic (3 h: 0.31 +/- 0.04 muM) ventilation compared with native controls (0.22 +/- 0.02 muM), whereas F-2-isoprostanes were elevated under both hyperoxic (3 h: 63 +/- 15 muM, p < .01) and anoxic (3 h: 50 +/- 9 pM, p < .01) ventilation compared with native controls (16 +/- 4 pM). We conclude that oxidative stress is increased in the lung alveolar lining layer during ischemia, during both anoxic and hyperoxic ventilation. This is paralleled by an increase rather than a decrease in alveolar antioxidant levels, suggested to reflect an adaptive response to oxidative stress during ischemia. (C) 2003 Elsevier Inc. All rights reserved.
