Volume 55, Issue 10 pp. 2762-2772
ORIGINAL ARTICLE

l-Citrulline treatment alters the structure of the pulmonary circulation in hypoxic newborn pigs

Eric B. McClellan

Eric B. McClellan

Department of Pediatrics, University of Utah Health, Salt Lake City, Utah

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Zhengming Wang

Zhengming Wang

Department of Pediatrics, University of Utah Health, Salt Lake City, Utah

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Kurt H. Albertine

Kurt H. Albertine

Department of Pediatrics, University of Utah Health, Salt Lake City, Utah

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Mark R. Kaplowitz

Mark R. Kaplowitz

Department of Pediatrics, University of Utah Health, Salt Lake City, Utah

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Yongmei Zhang

Yongmei Zhang

Department of Pediatrics, University of Utah Health, Salt Lake City, Utah

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Candice D. Fike

Corresponding Author

Candice D. Fike

Department of Pediatrics, University of Utah Health, Salt Lake City, Utah

Correspondence Candice D. Fike, Division of Neonatology, Department of Pediatrics, University of Utah Health, Williams Bldg, 295 Chipeta Way Salt Lake City, UT 84108-1220.

Email: [email protected]

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First published: 14 July 2020
Citations: 2

This study was presented in part at the 2018 and 2019 Pediatric Academic Society (PAS) meetings.

Abstract

Background

Dysregulated nitric oxide (NO) signaling contributes to chronic hypoxia (CH)-induced pulmonary hypertension (PH). NO signaling is improved and pulmonary vascular resistance (PVR) is reduced in CH piglets treated with the l-arginine-NO precursor, l-citrulline. We hypothesized that l-citrulline might cause structural changes in the pulmonary circulation that would contribute to the reduction in PVR and that the l-citrulline-induced structural changes would be accompanied by alterations in vascular endothelial growth factor (VEGF) signaling.

Methods

We evaluated small pulmonary arterial (PA) wall thickness, lung capillary density, and protein abundances of VEGF, VEGFR2, and phospho (p)-VEGFR2 in PA and peripheral lung samples of piglets raised in the lab in CH (10%-12% O2) from the day of life (DOL) 2 until DOL 11 to 12 or raised in room air (normoxia) by the vendor and studied on arrival to the lab on DOL 11 to 12. Some CH piglets were treated with oral l-citrulline (1-1.5 g/kg/d) starting on the third day of hypoxia.

Results

PA wall thickness was 32% less and lung capillary formation was nearly doubled in l-citrulline treated than untreated CH piglets. Both of these l-citrulline-induced structural changes in the pulmonary circulation were accompanied by altered amounts of VEGF protein but not by altered amounts of either VEGFR2 or p-VEGFR2 proteins.

Conclusions

Alterations in the structure of the pulmonary circulation in CH piglets by l-citrulline are unlikely to be mediated by overall VEGF signaling. Nonetheless, l-citrulline- induced structural changes should reduce PVR and thereby contribute to the amelioration of CH-induced PH.

CONFLICT OF INTERESTS

Candice D. Fike is listed as a co-inventor on a patent for the use of l-citrulline as a therapeutic treatment for lung conditions.

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