The hepatopulmonary syndrome (HPS) results from pulmonary microvascular dilatation in cirrhosis and is associated with increased pulmonary endothelial nitric oxide synthase (eNOS) levels. In the common bile duct ligation (CBDL) model, endothelin-1 (ET-1) released from the liver contributes to the rise in pulmonary eNOS and intrapulmonary vasodilatation. Whether substances, including ET-1, are found in the biliary tree and selectively enter the circulation after CBDL to influence the pulmonary vasculature is unknown. We assessed if control bile and fluid obtained from the obstructed biliary tree in CBDL animals contains ET-1 and alters eNOS expression and activity in bovine pulmonary artery endothelial cells (BPAECs). Control bile and biliary cyst fluid contained concentrations of ET-1 25-to 42-fold normal plasma levels, and hepatic venous concentrations of ET-1 were selectively increased after CBDL. Biliary cyst fluid caused a dose-dependent induction of eNOS messenger RNA (mRNA) (1.9-fold control), protein (2.5-fold control), and enzyme activity (2.2-fold control) maximal at a 1:10 dilution. The increases were associated with enhanced nitric oxide (NO) production ( The hepatopulmonary syndrome (HPS) is one well recognized complication of chronic liver disease characterized by intrapulmonary vasodilatation, which results in impaired arterial oxygenation. 1 It is found in 10% to 20% of patients with cirrhosis and studies in humans suggest that increased pulmonary nitric oxide (NO) production contributes to vasodilatation. 2 In previous studies, we have established chronic common bile duct ligation (CBDL) in the rat as a model of HPS. 3,4 These animals reliably develop increased pulmonary vascular endothelial nitric oxide synthase (eNOS) levels, intrapulmonary vasodilatation, and gas exchange abnormalities similar to human disease. In contrast, prehepatic portal hypertension induced by partial portal vein ligation (PVL) does not trigger pulmonary alterations suggesting that hepatic injury in addition to portal hypertension is required for the development of experimental HPS. Subsequently, we have found a selective and progressive increase in hepatic and plasma endothelin-1 (ET-1) levels after CBDL, which correlate directly with the onset and increase in pulmonary eNOS alterations and gas exchange abnormalities. 5 The rise in hepatic ET-1 levels is accompanied by immunohistochemical localization of ET-1 to biliary epithelium. Most recently, we have observed that delivery of a chronic low level ET-1 infusion to PVL animals triggers an increase in pulmonary eNOS levels, intrapulmonary vasodilatation, and gas exchange abnormalities indicative of HPS. 6 Together, these findings suggest that circulating ET-1 derived from the liver contributes to the development of experimental HPS.However, whether biliary production and release of ET-1 is involved in the unique susceptibility of CBDL animals to HPS remains undefined. We hypothesized that biliary obstruction may result in the release of mediators, including ET-1, from th...