The role of selective nitric oxide synthase inhibitor on nitric oxide and PGE2 levels in refractory hemorrhagic-shocked rats.

BACKGROUND: The up-regulation of nitric oxide (NO) and cyclooxgenase-2 (COX-2) has been implicated in the pathophysiology of hemorrhagic shock. We examined the effects of aminoguanidine (AG), which is a known inducible nitric oxide synthase (iNOS) inhibitor, and NS-398, a known COX-2 inhibitor, in our rat model of refractory hemorrhagic shock (RHS). MATERIAL AND METHODS: We measured tissue iNOS and COX-2 protein expression, brain and plasma nitrate/nitrite and prostaglandin E2 (PGE2) levels, plasma creatinine and glutamic oxalacetic transaminase (GOT) levels, quantified the histological damages in kidney, liver, lung, and brain, survival rate, and mean arterial blood pressure (MABP) in RHS rats. RESULTS: Semiquantitative analysis of tissues showed iNOS protein was not detected in AG + RHS rats but was detected in normal saline and NS-398 RHS rats. Tissue COX-2 protein was not detected in AG and NS-398 RHS rats but was detected in normal saline + RHS rats. The levels of brain and plasma nitrate/nitrite and PGE2 and plasma creatinine and GOT were significantly lower in the AG + RHS rat group when compared with the normal saline RHS rat group. Histological examinations also showed a reduction in organ damage for AG + RHS rats when compared with treated RHS rats. AG + RHS rats showed significantly increased survival and MABP level when compared with treated RHS rats. CONCLUSION: Our present findings suggest that NO produced by iNOS might result in organ damages. This in turn might lead to COX-2 up-regulation, and it increases the production of reactive oxygen species and toxic prostanoids. NO-mediated organ damage might be one way in which toxic products of COX-2 might further contribute to NO's deleterious effect in the later stages of RHS. It is therefore suggested that treatment of AG via inhibition of NO might contribute to improved physiological parameters and survival rates following RHS.

Effects of aminoguanidine and L-arginine methyl ester resuscitation following induction of fluid-percussion injury and severe controlled hemorrhagic shock in the rat brain.

OBJECT: In this study the authors compared the effects of both a selective inducible nitric oxide synthase (iNOS) inhibitor and a nonselective inhibitor on posttraumatic recovery and neuron survival by using a combined model of lateral fluid-percussion injury (FPI) and hemorrhagic shock (HS). METHODS: Male Sprague-Dawley rats weighing 300 to 350 g underwent FPI to the brain (3.5 atm) and hemorrhage to a mean arterial blood pressure (MABP) of 40 mm Hg for 1 hour. Rats were then resuscitated during 1 hour with bolus infusions of aminoguanidine (AG) or nitro-L-arginine methyl ester (L-NAME). Neuronal apoptosis was determined by performing Nissl staining and in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling technique. Rats infused with AG showed a significant increase in mean survival time and cerebral tissue perfusion, although the MABP and nitrate/nitrite levels did not significantly change compared with those in L-NAME-treated rats even though both animal groups had been subjected to combined FPI and HS, FPI alone, or HS alone. Furthermore, infusion of AG also significantly decreased the number of apoptotic neurons when compared with the number in rats treated with L-NAME. CONCLUSIONS: The authors asserted that treatment with AG, which causes the inhibition of iNOS, might contribute to improved physiological parameters and neuronal cell survival following FPI and HS.

Neuroprotective role of aminoguanidine in behavioral changes after blast injury.

BACKGROUND: The present study investigated the neuroprotective role of aminoguanidine, a known inducible nitric oxide synthase inhibitor, in both behavioral and morphologic changes in rats subjected to nonpenetrative blast injury. METHODS: Male Sprague-Dawley rats were randomly divided into groups to receive either normal saline or aminoguanidine (AG) before or after exposure to two blast dosages of either 2.8 or 20 kPa. The neurobehavioral alterations were determined by subjecting the animals to rotametric, grip-strength, passive avoidance, total and ambulatory locomotor activities, and acoustic startle response tests. RESULTS: Exposure to blast at 20 kPa resulted in a significant performance decrement on rotametric and grip-strength tests in rats treated with normal saline. In contrast, animals receiving AG either prophylactically before or after the blast seemed unaffected by the same blast. This finding also correlates well with histologic examination that showed a reduction in degenerating cortical neurons in AG-treated rats compared with those receiving saline injection. CONCLUSION: It is thus suggested that AG could play a neuroprotective role in rats subjected to blast exposure.

The role of inducible nitric oxide synthase inhibitor on the arteriolar hyporesponsiveness in hemorrhagic-shocked rats.

Hemorrhagic shock (HS) has been implicated in the induction of inducible nitric oxide synthase (iNOS) that leads to increase production of nitric oxide (NO). Recently, NO has been implicated to cause hyporesponsiveness of blood vessel in vitro towards vasoconstrictors in refractory (decompensated) HS. In our in vivo model, we examined the effects of aminoguanidine (AG), a known iNOS inhibitor, with angiotensin II (ANG II), a vasoconstrictor, following hemorrhagic shock decompensatory phase (HSDP) on percentage survival, vascular responsiveness, mean arterial blood pressure (MABP), heart rate and mean nitrate/nitrite levels in anaesthetized rats. HSDP (3 h) was achieved via constant pressure method (40-45 mmHg). MABP and heart rate was measured via the left carotid artery. Plasma collected from HSDP rats was used to measure nitrate/nitrite levels. Vascular hyporeactivity to ANG II was carried out using HSDP aortic strips, precontracted with KCl and noradrenaline. Sham-operated rats served as controls. HSDP rats decreased percentage survival, vascular contractility to ANG II and noradrenaline, MABP, heart rate while showing increased levels of nitrate/nitrite. Infusion of AG with ANG II, increased percentage survival and had reversed these cardiovascular effects of HSDP rats. This study indicates that excessive NO formation from iNOS activity induces vascular hyporeactivity and decompensation in HSDP. This might suggest that selective NOS inhibitor, AG, when coupled with ANG II, show reduction in NO's effect in HSDP.

Preservation of neurological functions by nitric oxide synthase inhibitors following hemorrhagic shock.

Excessive production of nitric oxide (NO) as result of inducible nitric oxide synthase (iNOS) induction has been implicated in the pathophysiology of hemorrhagic shock. Our aim was to study the effect of iNOS inhibitors, L-canavanine (50mg/kg) and N(G)-nitro- L-arginine methyl (L-NAME, 10mg/kg) and a resuscitation fluid, lactated Ringer's solution (3 times amount of blood lost), on survivability and neurological functions in rodents subjected to hemorrhagic shock. L-canavanine-treated rats had significantly higher survival rates (75%) compared to L-NAME-treated rats (44%) and lactated Ringer's solution-treated rats (40%), 72 h following hemorrhagic shock. A marked increase in the neurological performance was observed in L-canavanine-treated rats over the three-day period. Histological examinations also showed a reduction of degenerating neurons in L-canavanine-treated rats when compared to L-NAME-, lactated Ringer's solution- or un-treated rats. Mean arterial blood pressure (MABP), nitrate/nitrite level, glutamic oxalacetic transaminase (GOT) level, and blood gases were also significantly improved in L-canavanine-treated rats when compared to those of L-NAME-, lactated Ringer's solution- or un-treated rats. In conclusion, L-canavanine-treated rats were able to improve survivability, attenuate organ damage, and improve neurological outcome when compared to other treatment groups. It is therefore suggest that L-canavanine may be beneficial as a potentially useful therapeutic agent in treating neurological deficit as a result of hemorrhagic shock.