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2265434 
Journal Article 
Abstract 
Nitric oxide pathway dysfunction mediates diesel exhaust inhalation induced vascular dysfunction in man 
Langrish, JP; Mills, NL; Unosson, J; Barath, S; Soderberg, S; Pourazar, J; Blackwell, S; Megson, IL; Sandstrom, T; Newby, DE; Blomberg, A 
2010 
Yes 
American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970 
181 
A1717 
English 
is part of a larger document 3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans
Rationale.
We have previously shown that diesel exhaust inhalation causes impaired endothelial-dependent vasodilatation that may be driven by changes in nitric oxide (NO) release or bioavailability. In this study we investigated the role of NO in these adverse vascular effects.

Methods.
In a randomised double-blind cross-over trial, 16 healthy non-smoking volunteers (median age 23 years; 9 male, 7 female) were exposed to dilute diesel exhaust (particle concentration ~300 µg/m^3) or filtered air for 1 hour during intermittent exercise. Two hours after exposure, bilateral forearm blood flow was measured using venous occlusion plethysmography during unilateral intrabrachial infusion of acetylcholine (ACh; 5-20µg/min) and sodium nitroprusside (SNP; 2-8µg/min) in the presence of an “NO clamp” (NO synthase inhibitor, L-N-Gmonomethylarginine, 8 µg/min co-infused with the NO donor SNP at 90-900 ng/min titrated to restore basal blood flow).

Results.
Both ACh and SNP caused dose-dependent increases in blood flow (P<0.01 for both) that were similar (Figure) following exposure to filtered air and diesel exhaust.

Conclusion.
In the presence of NO synthase inhibition, and absence of endogenous NO, diesel exhaust inhalation does not cause further vasomotor dysfunction. This suggests that the adverse vascular effects of air pollution are mediated through the L-arginine-NO pathway. 
American Thoracic Society 2010 International Conference 
New Orleans, LA 
May 14-19, 2010 
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