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Int J Clin Exp Med 2010;3(1):1-9.

Original Article
Ciglitazone, a novel inhibitor of Lung Apoptosis following Hemorrhagic Shock

Ranjit S. Chima, Paul W. Hake, Giovanna Piraino, Prajakta Mangeshkar, Michael O’Connor, Basilia Zingarelli

Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine,
Cincinnati, OH

Received December 2, 2009; accepted December 10, 2009; available online January 1, 2010

Abstract: Apoptosis or programmed cell death has been demonstrated to play a role in the development of lung injury following
hemorrhagic shock. A major pathway modulating the apoptotic response is the phosphatidylinositol 3-kinase/serine/threonine kinase
(PI3K/Akt) pathway. Ciglitazone, a peroxisome proliferator-activated receptor-γ (PPARγ) ligand has previously been shown to attenuate
lung inflammation following hemorrhagic shock. In vivo similar ligands have demonstrated anti-apoptotic effects with a reduction in
organ injury in models of acute illness. In this study we examined the effect of ciglitazone on apoptosis and PI3K/Akt signaling in the
lung following severe hemorrhage and resuscitation. Hemorrhagic shock was induced in male Wistar rats by withdrawing blood from
the femoral artery to a mean arterial pressure of 50 mmHg. Animals were kept in shock for 3h at which time they were rapidly
resuscitated by returning their shed blood. At the time of resuscitation and every hour thereafter, groups of animals received ciglitazone
(10mg/kg) or DMSO intraperitoneally. Vehicle-treated rats had increased lung apoptosis following hemorrhage and resuscitation by
Tunel staining. This was associated with increased activity of caspase-3. Ciglitazone treatment reduced lung apoptosis with a
significant reduction in caspase-3 activity. This was associated with increased phosphorylation of the pro-survival kinase Akt. Thus, our
data suggest that ciglitazone, a PPARγ ligand, promotes cell survival in the lung following hemorrhagic shock. (IJCEM912002).

Key words: Hemorrhagic shock, lung injury, ciglitazone, peroxisome proliferator-activated receptor- γ, apoptosis, phospho-Akt

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Address all correspondence to:
Ranjit S. Chima M.D.
Division of Critical Care Medicine
Cincinnati Children's Hospital Medical Center
3333 Burnet Avenue
Cincinnati, OH 45229
Tel: (513) 636-4259
Fax: (513) 636-4267