Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nitric oxide synthesized by a constitutive enzyme is a widespread mediator of cell-cell and intracellular communication. This mediator provides a continuous vasodilator influence in the cardiovascular system, modifies the function of circulating cells, and acts as a neurotransmitter. After exposure to bacterial endotoxin or certain cytokines, expression of a second, inducible nitric oxide synthase occurs in a wide variety of tissues. This enzyme produces large amounts of nitric oxide for long periods and has been implicated in pathophysiologic changes seen in sepsis. In some cells, including macrophages, the nitric oxide synthesized by the inducible enzyme is toxic and appears to be an important mediator in host defense. Studies in animals and in vitro have demonstrated that nitric oxide released from inducible nitric oxide synthase in other tissues may cause profound vasodilation, damage to host cells, and cardiac dysfunction. The hypotension of endotoxin- or cytokine-induced shock can be reversed by inhibitors of nitric oxide synthase and these agents may provide a novel therapeutic approach to the treatment of severe septic shock. Preliminary studies in humans suggest that inhibition of nitric oxide synthase improves BP and stabilizes hemodynamics; effects on mortality rates remain to be determined.
 ...
PMID:Role of endogenous nitric oxide in septic shock. 792 96

Following trauma and tissue injury, patients frequently suffer infections and septic complications. Tissue injury is associated with the induction of the hepatic acute-phase response, but how this phenotypic expression by hepatocytes influences their subsequent response to endotoxin (lipopolysaccharide, LPS) or inflammatory cytokines is unknown. We have shown that both rat and human hepatocytes maximally express the enzyme-inducible nitric oxide synthase (iNOS) in response to a combination of LPS and the cytokines tumor necrosis factor (TNF), interferon-gamma (IFN-gamma), and interleukin-1. Furthermore, we have shown that the in vivo induction of the acute-phase response following tissue injury (hind limb turpentine injection) is not associated with hepatocyte iNOS expression. In this study, we show that the phenotypic change associated with the acute-phase response following tissue injury primes the hepatocyte to subsequently express iNOS in vitro in response to LPS alone as well as TNF and IFN-gamma. This expression of iNOS can be seen as early as 3 hr following the initial injury and lasts up to 24 hr. Early postinjury changes result in maximal expression following stimulation with TNF or IFN-gamma. Later (24 hr post-injury) changes reveal LPS to be the most potent inducer with as little as 0.01 microgram/ml LPS being required for iNOS mRNA expression. The in vivo correlate of tissue injury (turpentine injection) followed by sepsis (intraperitoneal LPS injection) resulted in a three- to fourfold rise in plasma levels of the stable end-products of nitric oxide production, nitrite, and nitrate (NO2- + NO3-), over levels seen in cases of sepsis alone.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Remote tissue injury primes hepatocytes for nitric oxide synthesis. 804 Nov 39

During sepsis and inflammation profound changes in physiological function are induced by a variety of mediators, including endotoxin, various cytokines, and NO. Many of these mediators, in addition to their other functions, induce the synthesis of NO through the induction of iNOS within a variety of cell types. The regulation of iNOS expression is quite complex. Of interest is the fact that the functions of NO during sepsis range from modulating perfusion to mediating cytotoxicity. In addition, it is unique that many tissues not characterized as being involved in immune function express iNOS in a manner similar to that of tissues involved in immune function. The role of NO during episodes of acute inflammation appears to be a protective one; however, there are examples of chronic localized inflammation in both animal and human models which suggest that chronic iNOS expression may be detrimental. Further investigations into the regulation and function of NO in both the acute and chronic settings are necessary in order to fully understand this small yet unique molecule.
 ...
PMID:Regulation and function of inducible nitric oxide synthase during sepsis and acute inflammation. 856 31

Nitric oxide can react with superoxide anion to form peroxynitrite. The resultant free radical can be rapidly protonated to yield even more toxic substances such as hydroxyl radical and nitric dioxide. The generation of either of these free radical species can promote lipid peroxidation and subsequent tissue injury if they are formed in excessive amounts. During sepsis, both nitric oxide synthesis and peroxynitrite production are substantially enhanced in a variety of tissues, effects which favor the development of lipid peroxidation. Consequently, this study was undertaken in conscious rats, to ascertain what effect lipopolysaccharide (LPS) has on inducible nitric oxide synthase expression in the small intestine and to determine whether this is associated with lipid peroxidation or morphologic injury. When examined by Western immunoblot analysis, significantly more inducible nitric oxide synthase immunoreactivity was detected in the ileum than in the jejunum 5 hr after treatment with intraperitoneal LPS (1 and 20 mg/kg). Further, using the thiobarbituric acid assay as an index of lipid peroxidation, it was demonstrated that significantly more thiobarbituric acid reactive substances were present in the ileal mucosa than in the jejunal mucosa after LPS (20 mg/kg) administration. However, LPS (20 mg/kg) resulted in morphologic damage to both segments of the intestinal epithelium. These data indicate that the gut is a target during sepsis and that regional differences exist within the small bowel with respect to induction of nitric oxide synthase and lipid peroxidation following LPS treatment. Thus, while induction of nitric oxide synthase during endotoxic shock may still represent a mechanism of local intestinal damage, it is not necessarily associated with enhanced lipid peroxidation.
 ...
PMID:Effects of lipopolysaccharide on intestinal injury; potential role of nitric oxide and lipid peroxidation. 866 Nov 95

1. The cardiovascular failure in sepsis may result from increased nitric oxide biosynthesis, through the diffuse expression of an inducible nitric oxide synthase. In such conditions, nitric oxide synthase inhibitors might be of therapeutic value, but detrimental side effects have been reported with their use, possibly related to the blockade of constitutive nitric oxide synthase. Therefore, the use of selective inhibitors of inducible nitric oxide synthase might be more suitable. The aim of this study was to evaluate the effects of L-canavanine, a potentially selective inhibitor of inducible nitric oxide synthase, in an animal model of septic shock. 2. Anaesthetized rats were challenged with 10 mg/kg lipopolysaccharide intravenously. One hour later, they randomly received a 5 h infusion of either L-canavanine (20 mg h-1 kg-1, n = 15), nitro-L-arginine methyl ester (5 mg h-1 kg-1, n = 13) or 0.9% NaCl (2 ml h-1 kg-1, n = 21). Lipopolysaccharide induced a progressive fall in blood pressure and cardiac index, accompanied by a significant lactic acidosis and a marked rise in plasma nitrate. All these changes were significantly attenuated by L-canavanine, which also improved the tolerance of endotoxaemic animals to acute episodes of hypovolaemia. In addition, L-canavanine significantly increased survival of mice challenged with a lethal dose of lipopolysaccharide. In contrast to L-canavanine, nitro-L-arginine methyl ester increased blood pressure at the expense of a severe fall in cardiac index, while largely enhancing lactic acidosis. This agent did not improve survival of endotoxaemic mice. In additional experiments, we found that the pressor effect of L-canavanine in advanced endotoxaemia (4 h) was reversed by L-arginine, confirming that it was related to nitric oxide synthase inhibition. In contrast, L-canavanine did not exert any influence on blood pressure in the very early stage (first hour) of endotoxaemia or in the absence of lipopolysaccharide exposure, indicating a lack of constitutive nitric oxide synthase inhibition by this agent. 3. In conclusion, L-canavanine produced beneficial haemodynamic and metabolic effects and improved survival in rodent endotoxic shock. The actions of L-canavanine were associated with a selective inhibition of inducible nitric oxide synthase and were in marked contrast to the deleterious consequences of nitro-L-arginine methyl ester, a non-selective nitric oxide synthase inhibitor, in similar conditions.
 ...
PMID:Beneficial effects of L-canavanine, a selective inhibitor of inducible nitric oxide synthase, during rodent endotoxaemia. 866 74

The aim of the present study was to test the hypothesis that pulmonary microvascular reactivity is depressed in sepsis and that inducible nitric oxide synthase (iNOS) contributes to the vascular hyporeactivity. Rats were made septic by cecal ligation and puncture. After 16 h, pulmonary vascular reactivity was evaluated by measurement of perfusion pressures while the vasculature was challenged with angiotensin II and KCl. The results showed that vascular reactivity was significantly depressed in lungs from septic rats in comparison to sham-operated controls. Pretreatment with the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME, 100 microM) restored the depressed vasoreactivity while the nitric oxide (NO) synthase substrate L-arginine (1 mM) reversed the contraction-restoring effect of L-NAME. NO production in lungs from septic rats increased about 4-fold in comparison to sham-operated controls. iNOS protein was expressed in lung tissues, mainly the resistance vessels, from septic rats but not from sham-operated controls. Reverse transcription and polymerase chain reaction also showed a strong induction of iNOS mRNA in lung tissues from septic rats. These results suggest that increased iNOS expression and NO production may contribute to depressed pulmonary vascular reactivity in sepsis.
 ...
PMID:Role of nitric oxide in sepsis-induced hyporeactivity in isolated rat lungs. 870 89

1. Prostaglandins are important regulatory mediators of cardiovascular and pulmonary functions which may become disordered in patients with sepsis. The mechanisms controlling their synthesis and release under these circumstances remain unclear. Cyclo-oxygenase (COX, prostaglandin G/H synthase) is a key enzyme in prostaglandin synthesis and has two isoforms (COX-1 and COX-2). COX-1 is constitutively expressed and is probably responsible for prostaglandin release under physiological conditions, whereas COX-2 is expressed at high levels upon induction. 2. We investigated the effect of lipopolysaccharide treatment in vivo on differential COX-1 and COX-2 mRNA expression in the rat. 3. The 2.8 kb COX-1 message was detected in all lungs and seven hearts of eight control rats. In lipopolysaccharide-treated animals, COX-1 expression was reduced by approximately 5-fold in lungs and 2-fold in hearts as quantified by densitometry. In parallel, a marked upregulation of COX-2 mRNA expression was observed. The 4.4 kb COX-2 transcript was absent or expressed at low level in control lungs and hearts, but was increased by approximately 7- and 12-fold in lipopolysaccharide-treated lungs and hearts respectively. Neither the down-regulation of COX-1 nor the upregulation of COX-2 mRNA induced by lipopolysaccharide was significantly affected by pretreatment with dexamethasone in lung and heart, although expression of inducible nitric oxide synthase, induced by lipopolysaccharide, was markedly inhibited in the same tissues. 4. The down-regulation of COX-1 and upregulation of COX-2 may contribute to the multi-organ failure seen in sepsis.
 ...
PMID:Differential regulation of cyclo-oxygenase-1 and cyclo-oxygenase-2 gene expression by lipopolysaccharide treatment in vivo in the rat. 877 37

The synthesis of nitric oxide (NO) and its targets are reviewed physiologically during sepsis and wound healing, a self-limiting process in which mechanisms are still identified incompletely. NO also plays an active and direct role during infection, aimed at protecting the host and destroying the microbe. During septic shock, an overproduction of NO has been described experimentally and clinically that might be responsible for the systemic vasodilatation with hyporesponsiveness to exogenous vasoconstrictive agents. The different manipulations of NO pathway during sepsis are described (transcription and post-transcription of iNOS, enzymatic function, substrate availability, NO concentration, and NO effector molecules), although their clinical benefit remains controversial.
 ...
PMID:Nitric oxide in sepsis. 879 70

Three different isoforms of the enzyme nitric oxide synthase (NOS) (EC 1.14.13.39) catalyze the formation of nitric oxide (NO) from l-arginine, which is then converted to l-citrulline. NO released by the constitutive isoforms is involved in a variety of physiologic functions, whereas larger amounts of NO released from the inducible isoform (iNOS) are mostly associated with inflammatory processes. Overproduction of NO in these processes including sepsis and autoimmune diseases can have deleterious consequences and pathophysiologic relevance. In this regard investigations of the regulation and function of iNOS to find specific iNOS inhibitors to block unwanted high levels of NO seem of great interest. The present article gives an overview of several methods and techniques employed to study the expression and regulation of the inducible nitric oxide synthase in in vivo and in vitro models of inflammation. The induction of iNOS was detected at different levels of expression and was compared to functional activity of NOS measured as enzyme activity and nitrite/nitrate production, two stable end products of the NO pathway. Differences in vivo and in vitro are compared and discussed.
 ...
PMID:Expression and Detection of Inducible Nitric Oxide Synthase in Experimental Models of Inflammation 881 45

Nitric oxide (NO), a free radical that is negatively inotropic in the heart and skeletal muscle, is produced in large amounts during sepsis by an NO synthase inducible (iNOS) by LPS and/or cytokines. The aim of this study was to examine iNOS induction in the rat diaphragm after Escherichia Coli LPS inoculation (1.6 mg/kg i.p.), and its involvement in diaphragmatic contractile dysfunction. Inducible NOS protein and activity could be detected in the diaphragm as early as 6 h after LPS inoculation. 6 and 12 h after LPS, iNOS was expressed in inflammatory cells infiltrating the perivascular spaces of the diaphragm, whereas 12 and 24 h after LPS it was expressed in skeletal muscle fibers. Inducible NOS was also expressed in the left ventricular myocardium, whereas no expression was observed in the abdominal, intercostal, and peripheral skeletal muscles. Diaphragmatic force was significantly decreased 12 and 24 h after LPS. This decrease was prevented by inhibition of iNOS induction by dexamethasone or by inhibition of iNOS activity by N(G)-methyl-L-arginine. We conclude that iNOS was induced in the diaphragm after E. Coli LPS inoculation in rats, being involved in the decreased muscular force.
 ...
PMID:Induction of diaphragmatic nitric oxide synthase after endotoxin administration in rats: role on diaphragmatic contractile dysfunction. 883 3


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>