Dexmedetomidine-ketamine Combination Mitigates Pulmonary Type-2 Cationic Amino Acid Transporter Isozymes Upregulation in Hemorrhagic Shock Rats

ObjectiveDexmedetomidine-ketamine combination has been reported to mitigate inducible nitric oxide synthase (iNOS) upregulation in rats with hemorrhagic shock. Type-2 cationic amino acid transporter isozymes, including CAT-2 and CAT-2B, are essential in regulating iNOS activity. We sought to elucidate the effects of dexme-detomidine-ketamine combination on regulating the expression of pulmonary CAT-2 isozymes in rats with hemorrhagic shock.MethodsForty adult male rats were randomized to one of four groups (10 rats in each group): sham-instrumentation (Sham); sham-instrumentation plus dexmedetomidine-ketamine combination (Sham-D + K); hemorrhagic shock (HS); or hemorrhagic shock plus dexmedetomidine-ketamine combination (HS-D + K). Rats in the HS and HS-D + K groups sustained controlled hemorrhagic shock (mean blood pressure was lowered to 40–45 mmHg by bloodletting for 60 minutes), followed by resuscitation with reinfusion of the shed blood mixed with saline. After close observation for 5 hours, the rats were sacrificed and the expression of CAT-2 isozymes was evaluated.ResultsSham-instrumentation and dexmedetomidine-ketamine combination did not affect CAT-2 isozymes expression, as pulmonary CAT-2 and CAT-2B mRNA concentrations in the Sham and Sham-D + K groups were low. Hemorrhagic shock significantly upregu-lated CAT-2 isozymes expression as pulmonary CAT-2 and CAT-2B mRNA concentrations in the HS group were significantly higher than in the two Sham groups. Pulmonary CAT-2 and CAT-2B mRNA concentrations in the HS-D + K group were significantly lower than in the HS group, indicating that the effects of hemorrhagic shock on upregulating CAT-2 isozymes expression were attenuated by dexmedetomidine-ketamine combination.ConclusionDexmedetomidine-ketamine combination mitigates pulmonary CAT-2 isozymes upregulation in rats with hemorrhagic shock.