RT Journal Article SR Electronic T1 ACE mediates ventilator-induced lung injury in rats via angiotensin II but not bradykinin JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 363 OP 371 DO 10.1183/09031936.00060207 VO 31 IS 2 A1 R. M. Wösten-van Asperen A1 R. Lutter A1 J. J. Haitsma A1 M. P. Merkus A1 J. B. van Woensel A1 C. M. van der Loos A1 S. Florquin A1 B. Lachmann A1 A. P. Bos YR 2008 UL http://erj.ersjournals.com/content/31/2/363.abstract AB Ventilator-induced lung injury is characterised by inflammation and apoptosis, but the underlying mechanisms are poorly understood. The present study proposed a role for angiotensin-converting enzyme (ACE) via angiotensin II (Ang II) and/or bradykinin in acute lung injury. The authors assessed whether ACE and, if so, Ang II and/or bradykinin are implicated in inflammation and apoptosis by mechanical ventilation. Rats were ventilated for 4 h with low- or high-pressure amplitudes in the absence or presence of the ACE inhibitor captopril. Nonventilated animals served as controls. ACE activity, Ang II and bradykinin levels, as well as inflammatory parameters (total protein, macrophage inflammatory protein-2 and interleukin-6) were determined. Apoptosis was assessed by the number of activated caspase-3 and TUNEL (terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate nick-end labelling)-positive cells. Bronchoalveolar lavage fluid ACE activity, levels of total protein, inflammatory parameters and the number of apoptotic cells were increased in the high-pressure amplitude group as compared with the control group. Blocking ACE activity by captopril attenuated inflammation and apoptosis in the latter group. Similar results were obtained by blocking Ang II receptors, but blocking bradykinin receptors did not attenuate the anti-inflammatory and anti-apoptotic effects of captopril. The current authors conclude that inflammation and apoptosis in ventilator-induced lung injury is, at least in part, due to angiotensin-converting enzyme-mediated angiotensin II production.