Vardenafil: a Phosphodiesterase-5 Inhibitor with protective action against the development of Multiple Organ Dysfunction Syndrome (MODS)

Objetivo : SDMO e uma patologia associada ao trauma inespecifico e grave, caracterizada por elevada morbidade e mortalidade. As intensas reacoes inflamatorias relacionadas geram micro-trombos disseminadas, o componente fisiopatologico mais relevante na inducao desta sindrome. A elevacao do oxido nitrico tem o potencial de reverter a vasoconstricao sistemica tipica, bem como a hiper-coagulacao induzida por plaquetas. O inhibitor da fosfodiesterase 5, vardenafil, poderia agir de forma protetora induzindo uma elevacao do NO sistemico, resultando em vasodilatacao difusa, alem de reducao de lesao endotelial e hiper-coagulacao induzida por plaquetas ,evitando, assim, o desenvolvimento da SDMO. Metodos: A SDMO experimental foi induzida atraves do modelo de lesoes micro-neurocirurgicas bilaterais do hipotalamo anterior. Os grupos experimentais de 10 ratos Wistar foram divididos em: a) Grupo Controle nao-operado; b) Grupo Operado; c) Grupo Operado Pre-tratado com vardenafil; d) Grupo Operado Pos-tratado com vardenafil. Os animais foram sacrificados apos 24 horas e submetidos ao exame histopatologico de cinco orgaos: cerebro, pulmoes, estomago, rins e, hepaticas. Resultados : lesoes eletroliticas estereotaxicas do hipotalamo anterior resultaram em um quadro patologico tipico da SDMO, com lesoes disseminadas em multiplos orgaos, provocadas, principalmente, por micro-trombos difusos. O pre-tratamento com vardenafil 2 horas antes das lesoes micro-neurocirurgica reduziu significativamente (p> 0,01) no desenvolvimento de lesoes multiorgânicas em 66,37%, em comparacao com o controle operado. O pos-tratamento com vardenafil, 2 horas apos as lesoes micro-neurocirurgica, tambem reduziu significativamente (p> 0,01) o desenvolvimento de lesoes multiorgânicas, de 59,64% em comparacao com o controle operado. Conclusao : O vardenafil, nas condicoes experimentais utilizadas,, mostrou funcionar como um agente de protecao contra a inducao de lesoes multiorgânicas da SDMO experimental.

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