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J Thorac Cardiovasc Surg 2002;124:668-674
© 2002 The American Association for Thoracic Surgery

General Thoracic Surgery (GTS)

Time-dependent effect of pneumonectomy on alveolar epithelial fluid clearance in rat lungs

From the Departments of Thoracic Surgery^a and Respiratory Medicine,^b Kanazawa Medical University, Uchinada, Ishikawa, Japan, and the Cardiovascular Research Institute, University of California, San Francisco,^c San Francisco, Calif.

This study was supported by a Grant for Collaborative Research from Kanazawa Medical University (S00-13, S01-11) and a Grant-In-Aid for Scientific Research from the Ministry of Education, Science, Sports and Culture of Japan (No. 11670600) and National Institutes of Health grant HL51854.

Received for publication July 27, 2001. Revisions requested Nov 19, 2001; revisions received Dec 12, 2001. Accepted for publication Dec 14, 2001. Address for reprints: Tsutomu Sakuma, MD, Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan (E-mail: sakumat-t{at}kanazawa-med.ac.jp).

Objective: Because pneumonectomy initiates compensatory growth of the remaining lung, we determined the time-dependent effects of pneumonectomy on alveolar fluid clearance capacity.
Methods: Alveolar fluid clearance capacity with the Evans blue-labeled albumin concentration was measured in rats 3 hours, 2 days, 7 days, 14 days, and 28 days after left pneumonectomy. The mechanisms responsible for the increase in alveolar fluid clearance were explored.
Results: Alveolar fluid clearance in the remaining lung was normal through 7 days and then increased 14 and 28 days after pneumonectomy. The increase in alveolar fluid clearance at 28 days after pneumonectomy was accounted primarily by an increase in amiloride-sensitive transport. The expression of epithelial sodium channel messenger RNA was increased in the remaining lung and in type II alveolar epithelial cells isolated from rats 28 days after pneumonectomy. The number of isolated type II cells was larger in pneumonectomized rats than in control rats. Also, ß-adrenergic agonist therapy increased the rate of alveolar fluid clearance at the 3-hour and 28-day time points.
Conclusions: The capacity to remove alveolar fluid in the remaining lung is maintained at a normal level for up to 7 days after pneumonectomy in a rat, and then there is a marked increase in amiloride-sensitive alveolar fluid transport capacity that might depend, at least in part, on increased expression of epithelial sodium channels in type II cells and in part on the increased number of type II cells.

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