R. Rodriguezroisin et al., PLATELET-ACTIVATING-FACTOR CAUSES VENTILATION-PERFUSION MISMATCH IN HUMANS, The Journal of clinical investigation, 93(1), 1994, pp. 188-194
We hypothesized that platelet-activating factor (PAF), a potent inflam
matory mediator, could induce gas exchange abnormalities in normal hum
ans. To this end, the effect of aerosolized PAF (2 mg/ml solution; 24
mu g) on ventilation-perfusion (V-A/Q) relationships, hemodynamics, an
d resistance of the respiratory system was studied in 14 healthy, nona
topic, and nonsmoking individuals (23+/-1 [SEM] yr) before and at 2, 4
, 6, 8, 15, and 45 min after inhalation, and compared to that of inhal
ed lyso-PAF in 10 other healthy individuals (24+/-2 yr) PAF induced, c
ompared to lyso-PAF, immediate leukopenia(P < 0.001) followed by a reb
ound leukocytosis (P+/-0.002), increased minute ventilation (P < 0.05)
and resistance of the respiratory system (P < 0.01), and decreased sy
stemic arterial pressure (P < 0.05). Similarly, compared to lyso-PAF,
Pa-O2 showed a trend to fall (by 12.2+/-4.3 mmHg, mean+/-SEM maximum c
hange from baseline), and arterial-alveolar O-2 gradient increased(by
16.7+/-4.3 mmHg) (P < 0.02) after PAF, because of V-A/Q mismatch: the
dispersion of pulmonary blood flow and that of ventilation increased b
y 0.45+/-0.1 (P < 0.01) and 0.29+/-0.1 (P < 0.04), respectively. We co
nclude that in normal subjects, inhaled PAF results in considerable im
mediate V-A/Q inequality and gas exchange impairment. These results re
inforce the notion that PAF may play a major role as a mediator of inf
lammation in the human lung.