Progressive inflammatory and structural changes in the pulmonary vasculature of monocrotaline-treated rats.

The progression of changes in the bronchus-associated and intraacinar pulmonary arteries of rats treated with a single dose of monocrotaline (60 mg/kg) was evaluated by quantitative light and electron microscopy. The relative volume of vessel wall components was normalized to the surface area of the adventitial sheath. An increased relative volume of media was evident in intraacinar pulmonary arteries by 4 hr post-treatment. This increase may represent vascular smooth muscle contraction. Significant increases in adventitial mononuclear inflammatory cells were evident by 8-16 hr post-treatment in intraacinar pulmonary arteries and veins but not until 14 days post-treatment in major, bronchus-associated pulmonary arteries. Inflammatory cell influxes were associated with increased relative volume of adventitia, largely due to increased extracellular space. By 22 days posttreatment, there was right ventricular hypertrophy and a marked mononuclear vasculitis in major and intraacinar pulmonary arteries as well as intraacinar veins (confirmed as such by vascular perfusion of carbon/gelatin). There was increased relative medial volume in both major and intraacinar pulmonary arteries associated with increased extracellular matrix composed largely of collagen. Intraacinar veins developed intimal plaques of smooth muscle in a collagenous matrix. We conclude that (1) adventitial inflammation precedes morphologic evidence of medial changes in monocrotaline-induced pulmonary hypertension, (2) involvement of intraacinar arteries precedes that of major bronchus associated arteries, and (3) both pulmonary arteries and veins are involved in monocrotaline-induced pulmonary vascular disease in the rat.