Inflammation-induced vasoconstrictor hyporeactivity is caused by oxidative stress

J Am Coll Cardiol. 2003 Nov 5;42(9):1656-62. doi: 10.1016/j.jacc.2003.06.002.

Abstract

Objectives: We sought to determine the role of oxidative stress in the development of vascular dysfunction in inflammation.

Background: Hyporeactivity to catecholamines and other vasoconstrictors is present in acute inflammation. Because oxidative stress plays a significant role in inflammation, impaired responsiveness may be overcome by anti-oxidants.

Methods: In randomized, double-blind, cross-over studies, forearm blood flow (FBF) responses to norepinephrine (NE), angiotensin II (ANG II), and vasopressin (VP) were assessed before and 4 h after induction of systemic inflammation by low doses of Escherichia coli endotoxin (lipopolysaccharide [LPS], 20 IU/kg intravenously) or after placebo in healthy volunteers. Furthermore, the effect of intra-arterial vitamin C (24 mg/min) or placebo on NE-induced or ANG II-induced vasoconstriction was studied after LPS.

Results: Administration of LPS caused systemic and forearm vasodilation, increased white blood cell count, elevated body temperature, and reduced vitamin C plasma concentrations. Lipopolysaccharide decreased the responses of FBF to NE by 59%, to ANG II by 25%, and to VP by 51% (n = 9, p < 0.05, all effects). Co-administration of vitamin C completely restored the response to NE and to ANG II, which was comparable to that observed under baseline conditions (n = 8).

Conclusions: E. coli-endotoxemia reduces FBF responsiveness to vasoconstrictors. The hyporeactivity can be corrected by high doses of vitamin C, suggesting that oxidative stress may represent an important target for inflammation-induced impaired vascular function.

MeSH terms

  • Adult
  • Angiotensin II / pharmacology*
  • Antioxidants / pharmacology*
  • Ascorbic Acid / pharmacology*
  • Endotoxemia / physiopathology*
  • Escherichia coli Infections / physiopathology
  • Humans
  • Inflammation / physiopathology
  • Male
  • Oxidative Stress*
  • Regional Blood Flow / drug effects
  • Regional Blood Flow / physiology
  • Vasoconstriction / drug effects*
  • Vasoconstriction / physiology*
  • Vasoconstrictor Agents / pharmacology*
  • Vasopressins / pharmacology*

Substances

  • Antioxidants
  • Vasoconstrictor Agents
  • Vasopressins
  • Angiotensin II
  • Ascorbic Acid