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Query: UMLS:C0243026 (
sepsis
)
52,417
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Polymicrobial
sepsis
is characterized by an early, hyperdynamic phase (i.e., 2-10 h after cecal ligation and puncture [CLP]) followed by a late, hypodynamic phase (16 h after CLP or later). Although nitric oxide (NO) plays an important role in the pathophysiologic response during
sepsis
, it remains unknown how early NO is upregulated after the onset of
sepsis
and which organs are responsible for producing the increased amount of NO. To study this, male rats were subjected to
sepsis
by CLP followed by fluid resuscitation. Blood samples were then taken at 2, 5, 10, or 20 h after CLP or sham operation. In additional groups of animals, the kidneys, small intestine, heart, liver, and lungs were harvested at 5 or 10 h after CLP. Plasma and tissue levels of nitrate and nitrite (NO3-/NO2-, stable products of NO) were determined by using a colorimetric assay.
Inducible NO synthase
(
iNOS
) mRNA was examined in various tissues harvested at 10 h after CLP by reverse transcription-polymerase chain reaction (RT-PCR) technique. The results indicate that plasma levels of NO3-/NO2- (mainly reflecting
iNOS
activity) did not increase at 2-5 h but were significantly elevated at 10-20 h after CLP. Tissue levels of NO3-/NO2- increased significantly in the kidneys, small intestines, heart, and liver at 10 h but not at 5 h after CLP. Similarly,
iNOS
gene expression was upregulated in the kidneys, small intestines, and liver. Thus, the above organs appear to be important sites responsible for producing the increased NO during
sepsis
. Because we previously showed that the hyperdynamic response occurs as early as 2 h after CLP and because
iNOS
-derived NO production is not upregulated earlier than 10 h after the onset of
Sepsis
, it appears that factors other than NO are responsible for producing the hyperdynamic response during
sepsis
.
...
PMID:Upregulation of inducible nitric oxide synthase and nitric oxide occurs later than the onset of the hyperdynamic response during sepsis. 1077 23
Clinical and experimental studies have shown that myocardial dysfunction is an early event during endotoxemia or septic shock. Several reports have shown that rodents submitted to a mild heat shock become resistant to lipopolysaccharides (LPS) or
sepsis
. The most abundant of the heat shock proteins (HSP), the HSP70, has been postulated to be the principal mediator of the observed protection against endotoxemia. We have tested the hypothesis that a protective effect against endotoxemia is achievable by the increased presence of the HSP70 in rodent cardiomyocytes. We have found that a transgenic mouse line overexpressing the rat HSP70 gene in the heart exhibits an increased tolerance to LPS treatment (control estimated survival function [S(t)] = 0.538, transgenic S(t) = 0.787, P < 0.05). Interestingly, the increased presence of the HSP70 in the hearts of these mice results in a decrease in the activation of the
inducible nitric oxide synthase
(
iNOS
) after LPS treatment. We conclude that HSP70 protection against LPS is most probably mediated through the modulation of
iNOS
activation and the subsequent decreased synthesis of nitric oxide in cardiomyocytes.
...
PMID:Protection against endotoxemia by HSP70 in rodent cardiomyocytes. 1077 20
Impaired vascular responsiveness in
sepsis
may lead to maldistribution of blood flow in organs. We hypothesized that increased production of nitric oxide (NO) via
inducible nitric oxide synthase
(
iNOS
) mediates the impaired dilation to ACh in
sepsis
. Using a 24-h cecal ligation and perforation (CLP) model of
sepsis
, we measured changes in arteriolar diameter and in red blood cell velocity (V(RBC)) in a capillary fed by the arteriole, following application of ACh to terminal arterioles of rat hindlimb muscle.
Sepsis
attenuated both ACh-stimulated dilation and V(RBC) increase. In control rats, arteriolar pretreatment with the NO donors S-nitroso-N-acetylpenicillamine or sodium nitroprusside reduced diameter and V(RBC) responses to a level that mimicked
sepsis
. In septic rats, arteriolar pretreatment with the "selective"
iNOS
blockers aminoguanidine (AG) or S-methylisothiourea sulfate (SMT) restored the responses to the control level. The putative neuronal NOS (nNOS) inhibitor 7-nitroindazole also restored the response toward control. At 24-h post-CLP, muscles showed no reduction of endothelial NOS (eNOS), elevation of nNOS, and, surprisingly, no induction of
iNOS
protein; calcium-dependent constitutive NOS (eNOS+nNOS) enzyme activity was increased whereas calcium-independent
iNOS
activity was negligible. We conclude that 1) AG and SMT inhibit nNOS activity in septic skeletal muscle, 2) NO could impair vasodilative responses in control and septic rats, and 3) the source of increased endogenous NO in septic muscle is likely upregulated nNOS rather than
iNOS
. Thus agents released from the blood vessel milieu (e.g., NO produced by skeletal muscle nNOS) could affect vascular responsiveness.
...
PMID:Nitric oxide produced via neuronal NOS may impair vasodilatation in septic rat skeletal muscle. 1077 25
Lipopolysaccharide (LPS)-regulated contractility in pericytes may play an important role in mediating pulmonary microvascular fluid hemodynamics during inflammation and
sepsis
. LPS has been shown to regulate inducible nitric oxide (NO) synthase (
iNOS
) in various cell types, leading to NO generation, which is associated with vasodilatation. The purpose of this study was to test the hypothesis that LPS can regulate relaxation in lung pericytes and to determine whether this relaxation is mediated through the
iNOS
pathway. As predicted, LPS stimulated NO synthesis and reduced basal tension by 49% (P < 0.001). However, the NO synthase inhibitors N (omega)-nitro-L-arginine methyl ester, aminoguanidine, and N (omega)-monomethyl-L-arginine did not block the relaxation produced by LPS. In fact, aminoguanidine and N (omega)-monomethyl-L-arginine potentiated the LPS response. The possibility that NO might mediate either contraction or relaxation of the pericyte was further investigated through the use of NO donor compounds; however, neither sodium nitroprusside nor S-nitroso-N-acetylpenicillamine had any significant effect on pericyte contraction. The inhibitory effect of aminoguanidine on LPS-stimulated NO production was confirmed. This ability of LPS to inhibit contractility independent of
iNOS
was also demonstrated in lung pericytes derived from
iNOS
-deficient mice. This suggests the presence of an
iNOS
-independent but as yet undetermined pathway by which lung pericyte contractility is regulated.
...
PMID:Lipopolysaccharide induces relaxation in lung pericytes by an iNOS-independent mechanism. 1078 17
Despite recent investigations, the mechanisms responsible for intestinal epithelial injury during endotoxemia remain unclear. The present study tests the hypothesis that epithelial necrosis and/or apoptosis correlate with nitric oxide (NO) dysregulation in a nonischemic model of
sepsis
-induced ileal injury. To test this hypothesis, a well-established in situ, autoperfused, feline ileal preparation was employed. After endotoxin (lipopolysaccharide [LPS], 3 mg/ kg, intravenously; n = 9) or vehicle (control; n = 5) treatment, ileal segments were obtained at baseline, 2 and 4 h for simultaneous evaluations of cellular and mitochondrial ultrastructure, immunoprevalence of
inducible nitric oxide synthase
(
iNOS
) and 3-nitrotyrosine (a stable biomarker of peroxynitrite), and histochemical evidence of apoptosis. Epithelial necrosis was prominent by 2 h post-LPS, despite unaltered global ileal tissue oxygen content, blood volume, and blood flow. Significant evidence of apoptosis and increases in the immunoprevalence of
iNOS
and 3-nitrotyrosine were not evident until 4 h post-LPS. These results suggest that the early ileal mucosal necrosis may be due to LPS-induced activation of inflammatory pathways and/or microcirculatory disturbances, whereas NO dysregulation may participate in later events, including protein nitration and epithelial apoptosis.
...
PMID:Endotoxin-induced ileal mucosal injury and nitric oxide dysregulation are temporally dissociated. 1080 78
We studied the role of
inducible nitric oxide synthase
(
iNOS
) in septic lung injury using a novel and selective
iNOS
inhibitor (a fused piperidine derivative; ONO-1714) following a cecal ligation and puncture (CLP) procedure. All rats that received CLP died within 48 h after the intervention. The subcutaneous injection of ONO-1714 at 0.03 mg/kg every 12 h resulted in a significantly longer survival time than the saline control only when administration was started 12 h after the CLP procedure. The other administration schedules, which started immediately or 6 h after the intervention, did not show any improvement in the survival rates in comparison with the saline control. The administration of ONO-1714 at higher (0.1 mg/ kg) or lower (0.01 mg/kg) doses when given anytime after the intervention did not improve the survival rates. The NO(x) (NO(2)(-) + NO(3)(-)) levels in the plasma significantly increased 12 h after intervention in comparison with NO(x) at 0 h and thereafter further increased in parallel with the time elapsed. The CLP rats that were initially treated with ONO-1714 (0.03 mg/kg subcutaneously every 12 h) 12 h after intervention showed significantly reduced NO(x) levels in the plasma in comparison with the saline control. The NO synthase activity in lung homogenates increased from 6 to 24 h after the CLP and thereafter decreased to 42 h. The administration of ONO-1714 inhibited
iNOS
activity (under calcium-free conditions) in preference to total
iNOS
activity (under calcium-dependent conditions) in lung homogenates, which thus suggested that this compound selectively inhibited
iNOS
in lung tissue. The
iNOS
protein expression in the lung and liver homogenates showed a similar time course with alterations of NOS activity, namely a maximum level at 24 h after the intervention followed by decreasing levels to 42 h. On the other hand, other isozymes of NOS, eNOS, and nNOS in lung homogenates, were constantly expressed over the time course after the CLP. Since the
iNOS
mRNA expression in lung homogenates continued to elevate until 42 h, the decrease in
iNOS
activity and protein expression later than 24 h after the CLP was thus considered to be due to some posttranscriptional mechanism during the late phase of
sepsis
. In conclusion, intervention with a potent and selective
iNOS
inhibitor seemed to improve survival in CLP rats when used at the appropriate doses and time points. However, the self-limited mechanism of
iNOS
regulation in the lungs may also indicate that
iNOS
plays only a limited role in
sepsis
and septic shock.
...
PMID:Evaluating the role of inducible nitric oxide synthase using a novel and selective inducible nitric oxide synthase inhibitor in septic lung injury produced by cecal ligation and puncture. 1093 11
Inflammation of the intestinal tract remains a very serious concern in the clinical setting. Unfortunately, to date, the mechanisms underlying many inflammatory conditions such as
sepsis
or inflammatory bowel diseases are poorly understood and our therapeutic interventions are less than ideal. Over the past decade, an abundance of research has been directed toward the role of nitric oxide (NO) in intestinal inflammation. It has become apparent that NO might have a dichotomous role as both a beneficial and detrimental molecule. Nitric oxide is a weak radical produced from L-arginine via the enzyme nitric oxide synthase (NOS). NOS exists in three distinct isoforms; constitutively (cNOS) expressed neuronal NOS (NOS1 or nNOS) and endothelial NOS (NOS3 or eNOS) or an inducible isoform (NOS2 or
iNOS
) capable of high production output of NO during inflammation. Constitutively expressed NOS has been shown to be critical to normal physiology and inhibition of these enzymes (nNOS or eNOS) caused damage. It has been proposed that the high output production of NO from
iNOS
causes injury, perhaps through the generation of potent radicals such as peroxynitrite and hence may explain the apparent dichotomous role of NO. However, recent studies have challenged this simple paradigm providing evidence that
iNOS
may have some protective role in some inflammatory models. Moreover, the importance of peroxynitrite has been questioned. In this review we discuss the role of cNOS and
iNOS
in intestinal inflammation and provide an overview of peroxynitrite in intestinal inflammation, highlighting some of the controversy that exists.
...
PMID:Nitric oxide and intestinal inflammation. 1096 57
Hypotension and shock observed in
sepsis
, SIRS, and tumor necrosis factor (TNF) or cytokine-based cancer treatment are the consequence of excessive nitric oxide (NO) production and subsequent soluble guanylate cyclase (sGC)-mediated vascular smooth muscle relaxation. We demonstrate here that, while NO synthase (NOS) inhibitors exacerbated toxicity, inhibitors of sGC activation protected against TNF-induced lethality, bradycardia, and hypotension. Importantly, sGC inhibition did not interfere with the antitumor activity of TNF. Using NOS inhibitors or
iNOS
-deficient animals, we furthermore observed that no protection against TNF toxicity could be obtained in the absence of NO. These data imply that
iNOS
- (and not eNOS-) derived NO is an endogenous protective molecule indispensable to survive a TNF challenge and exerting this beneficial effect via sGC-independent mechanisms.
...
PMID:Protection against TNF-induced lethal shock by soluble guanylate cyclase inhibition requires functional inducible nitric oxide synthase. 1098 65
Previous studies have demonstrated that
inducible nitric oxide synthase
(
iNOS
) plays a key pathophysiologic role during
sepsis
. The present study was designed to delineate the consequences of
iNOS
activation on renal microvascular function. Male Sprague-Dawley rats were given intraperitoneal injections of lipopolysaccharide (LPS; 4 mg/kg) at 16 h and 4 h before experimentation. Afferent and efferent arteriolar diameters from LPS-treated and control rats were assessed in vitro with the use of the blood perfused juxtamedullary nephron technique. Basal afferent and efferent arteriolar diameters of LPS-treated rats averaged 19.7 +/- 0.9 (n = 7) and 18.3 +/- 1.0 microm (n = 5), respectively, and were similar to those of control rats (20.8 +/- 0.3 [n = 6] and 18.4 +/- 0.6 microm [n = 6], respectively). Superfusion with the selective
iNOS
inhibitor S,S'-(1,3-phenylenebis[1,2-ethanediyl]) bisisothiourea (PBIT), at the doses of 0.01, 0.1, and 1 microM, significantly decreased afferent and efferent arteriolar diameters in a dose-dependent manner, whereas afferent or efferent arteriolar diameters of control rats were not altered in response to the same doses of PBIT. In the second series of experiments, superfusion with 10 microM acetylcholine (ACh) significantly increased afferent and efferent arteriolar diameters of LPS-treated rats by 14.9 +/- 1.6% (n = 9) and 6.6 +/- 1.1% (n = 6), respectively. The ACh-induced afferent and efferent arteriolar dilator responses were inhibited by superfusion with the nonselective NOS inhibitor N:(omega)-nitro-L-arginine (100 microM). However, afferent and efferent arteriolar dilator responses to ACh were significantly enhanced during selective
iNOS
inhibition with 1 microM PBIT (40.1 +/- 0.7% and 25.2 +/- 1.3%, respectively). These results suggest that activation of
iNOS
by LPS increases the influence of nitric oxide on afferent and efferent arteriolar tone and impairs endothelium-dependent nitric oxide effects.
...
PMID:Inducible nitric oxide synthase attenuates endothelium-dependent renal microvascular vasodilation. 1100 10
Neutrophils (PMN) are proposed to contribute to hepatic dysfunction during
sepsis
. Transmigrating PMN have been demonstrated to adhere to and injure parenchymal cells (hepatocytes); however, the effect of
sepsis
-activated PMN on hepatic macrophages or Kupffer cells (KC) is poorly characterized. We hypothesize that PMN influence KC inflammatory mediator production, including nitric oxide. Rodent KC were co-cultured with PMN obtained from controls (Norm-PMN) or endotoxemic rats [lipopolysaccharide (LPS)-PMN] for 18 h. After an 18-h incubation, supernatants and cell lysates of the KC were analyzed for nitric oxide (NO) production. Co-cultures with LPS-PMN/KC demonstrated significantly increased production of nitrite and up-regulation of
inducible nitric oxide synthase
(
iNOS
) protein compared to KC alone or Norm-PMN/KC co-cultures. Immunohistochemistry revealed preferential
iNOS
protein staining in the cytoplasm of KC cultured with LPS-PMN compared to controls. Nitrite production in co-cultures of KC and LPS-PMN where cell contact was inhibited by a cell impermeable but diffusable membrane was significantly reduced. These data provide evidence that KC can be stimulated directly by activated PMN for production of NO. Further, they suggest another mechanism by which PMN modulate hepatic function during
sepsis
.
...
PMID:Activated neutrophils induce nitric oxide production in Kupffer cells. 1102 60
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