Biochemical reaction products of nitric oxide as quantitative markers of primary pulmonary hypertension.

Primary pulmonary hypertension (PPH) is a rare and fatal disease of unknown etiology. Inflammatory oxidant mechanisms and deficiency in nitric oxide (NO) have been implicated in the pathogenesis of pulmonary hypertension. In order to investigate abnormalities in oxidants and antioxidants in PPH, we studied intrapulmonary NO levels, biochemical reaction products of NO, and antioxidants (glutathione [GSH], glutathione peroxidase [GPx], and superoxide dismutase [SOD]) in patients with PPH (n = 8) and healthy controls (n = 8). Intrapulmonary gases and fluids were sampled at bronchoscopy. Pulmonary hypertension was determined by right-heart catheterization. NO and biochemical reaction products of NO in the lung were decreased in PPH patients in comparison with healthy controls (NO [ppb] in airway gases: control, 8 +/- 1; PPH, 2.8 +/- 0. 9; p = 0.016; and NO products [microM] in bronchoalveolar lavage fluid [BALF]: control, 3.3 +/- 1.05; PPH, 0.69 +/- 0.21; p = 0.03). However, GSH in the lungs of PPH patients was higher than in those of controls (GSH [microM] in BALF: 0.55 +/- 0.04; PPH, 0.9 +/- 0.1; p = 0.015). SOD and GPx activities were similar in the two groups (p >/= 0.50). Biochemical reaction products of NO were inversely correlated with pulmonary artery pressures (R = -0.713; p = 0.047) and with years since diagnosis of PPH (R = -0.776; p = 0.023). NO reaction products are formed through interactions between oxidants and NO, with the end products of reaction dependent upon the relative levels of the two types of molecules. The findings of the study therefore show that NO and oxidant reactions in the lung are related to the increased pulmonary artery pressures in PPH.

Role of nitric oxide in poly(I-C)-induced endothelial cell expression of leukocyte adhesion molecules.

Polyinosinic-polycytidylic acid [poly(I-C)] is a synthetic double-stranded RNA (dsRNA) that simulates a viral-infected state in cells. It has been shown that viral infection, as well as poly(I-C), stimulates leukocyte adhesion to endothelial cell (EC) monolayers and that this is mediated through the surface expression of the adhesion molecules E-selectin, vascular cell adhesion molecule 1 (VCAM-1), and intercellular adhesion molecule 1. We have tested the involvement of nitric oxide (NO) in poly(I-C)-induced monocytic cell adhesion to human vascular EC. Using primary cultured EC for these studies, we confirmed the results from previous reports that these cells have higher basal levels of NO production than passaged cells. Poly(I-C)-induced monocytic cell adhesion to primary EC was concentration-dependently inhibited by 40-74% by the nitric oxide synthase (NOS) inhibitor NG-methyl-L-arginine (L-NMA), as well as three other NOS inhibitors, without significantly affecting interleukin-1 beta-induced adhesion. L-NMA inhibited poly(I-C)-induced surface expression of E-selectin and VCAM-1 by 25 and 45%, respectively, and mRNA levels of E-selectin and VCAM-1 by 62 and 74%, respectively. Primary EC transiently transfected with a plasmid containing an E-selectin promoter-driven luciferase reporter gene showed that L-NMA treatment reduced poly(I-C)-induced E-selectin promoter activity to basal levels. Electrophoretic mobility shift analysis indicated that poly(I-C)-induced nuclear factor-kappa B (NF-kappa B) binding to a radiolabeled oligonucleotide corresponding to the consensus NF-kappa B binding domain of the E-selectin promoter was decreased by L-NMA pretreatment. Hence, NO appears to augment E-selectin gene expression in response to poly(I-C) at the transcriptional level in vascular EC. Collectively, these data support the hypothesis that NO augments poly(I-C)-induced EC activation. These data suggest a novel role for NO as a response mediator in dsRNA-induced leukocyte adhesion to EC.

Nitric oxide inhibits inflammatory cytokine production by human alveolar macrophages.

High levels of nitric oxide (NO) have been reported in exhaled air of asthmatic individuals. Because alveolar macrophages (AM) are major producers of cytokines, and bronchoalveolar lavage fluid (BALF) from asthmatic individuals contains increased levels of inflammatory cytokines, this study was undertaken to determine whether NO modified the production of inflammatory cytokines by human AM. AM were obtained from normal volunteers by fiberoptic bronchoscopy. Tumor necrosis factor-alpha (TNF-alpha) production stimulated by lipopolysaccharide (LPS; 0.5 microg/ml) was measured with an enzyme-linked immunosorbent assay (ELISA). NO generated from 2,2-(hydroxynitrosohydrazono)-bis-ethanamine (DETA NONOate) (0.1 to 1.0 mM) inhibited TNF-alpha secretion in a dose-dependent manner. At 1 mM DETA NONOate, mean inhibition (+/- SEM) of TNF-alpha secretion was 56 +/- 4% (P = 0.002). To determine whether this effect was cytokine specific, interleukin-1beta (IL-1beta) and macrophage inflammatory protein-1alpha (MIP-1alpha) were evaluated, and DETA NONOate was also found to inhibit both of these cytokines. Basal cytokine levels from unstimulated AM were unaffected by NO. These findings indicate that NO is a potent inhibitor of cytokine production by stimulated human AM.

Decreased Cu,Zn-SOD activity in asthmatic airway epithelium: correction by inhaled corticosteroid in vivo.

To investigate the antioxidant response of respiratory epithelium to the chronic airway inflammation in asthma, the major intracellular antioxidants [copper and zinc-containing superoxide dismutase (Cu,Zn-SOD) and manganese-containing SOD (Mn-SOD), catalase, and glutathione peroxidase] were quantitated in bronchial epithelial cells of healthy control and asthmatic individuals. Although catalase and glutathione peroxidase in bronchial epithelium of asthmatics were similar to control SOD activity in asthmatics not on inhaled corticosteroid (-CS) was lower than asthmatics on inhaled corticosteroid (+CS) and controls. Investigation of Mn-SOD and Cu,Zn-SOD activities revealed that the lower SOD activity in asthmatics -CS was because of decreased Cu,Zn-SOD activity. However, Mn-SOD and Cu,Zn-SOD mRNA and protein levels were similar among asthmatics -CS, asthmatics +CS, and controls. Importantly, Cu,Zn-SOD specific activity in asthmatics -CS was decreased in comparison with control and asthmatics +CS. Furthermore, in paired comparisons of asthmatics -CS and +CS, inhaled corticosteroids resulted in normalization of bronchial epithelial Cu,Zn-SOD specific activity. These findings suggest loss of Cu,Zn-SOD activity in asthma is related to inflammation, perhaps through oxidant inactivation of Cu,Zn-SOD protein.